The biceps brachii is a large muscle located on the ventral surface of the shoulder bone. Most often it is called the biceps. The main function of the biceps is flexion at the elbow joint. Sometimes a rupture of the biceps occurs, resulting in loss of flexion function.
The biceps muscle is formed by two heads holding the muscle in its zone. The heads end in a tendon that is attached to the radius. At the top, the muscle attaches to the shoulder blade.
In cases where there is a complete rupture of the biceps, there is an upward displacement of the muscle. In this position, the tendon does not adhere to its designated place on the bone.
Gap features
Most often, the injury is diagnosed in men over 35 years old. In women, a ruptured bicep is rarely detected.
Tendons lose strength with age, and rupture can occur when carrying heavy loads. To avoid it, it is necessary to perform a warm-up before physical effort, but people do not attach any importance to this requirement.
You can strengthen the tendon if you start playing sports. Otherthere is no way to make the bicep stronger.
Risk factors for a bicep tear are:
- use of corticosteroids – use of certain drugs leads to necrosis and tendon ruptures;
- smoking - nicotine destroys tendon tissues;
- taking fluoroquinolone antibiotics;
- some systemic pathologies.
Gap Types
Biceps ruptures can be complete or partial. The latter include incomplete ruptures, in which part of the tendons remains intact, the muscle does not move.
With a complete rupture, the muscle completely moves away from the bone, is pulled together by contraction to the shoulder area. A distal biceps tear can occur with equal frequency on the left and right arm.
With a complete break, you can bend your arm at the elbow. This is due to the fact that not only the biceps muscle is responsible for the flexion of the limb, but also the shoulder muscle. If the integrity of the biceps is not restored, then the flexion will be performed only by the shoulder muscle and only by 50-60% of the strength of the elbow flexion. For a normal life, these indicators are enough, but, for example, it will be problematic to bring purchases from the car, and any physical activity will be impossible to perform at all.
Clinical picture
When the bicep is torn, there is a click in the elbow area. After an injury, the muscle shifts upward, its abdomen takes the form of a ball. Often there are hematomas in the area of injury.
Immediately after the break occursstrong pain. It gradually subsides and after a couple of weeks it disappears completely. In addition to the pain syndrome, it is noted:
- swelling in the elbow area;
- feels weak in elbow when bending;
- bruises are visible in the separation zone, which become more extensive and can reach the hand;
- when rotating the forearm, weakness, soreness occurs.
When the ligaments of the biceps are torn, there is a spherical seal in the upper part of the shoulder. It occurs due to a contracted muscle. A depression zone is observed along the front surface of the elbow.
In some people, the gap is asymptomatic. They feel a tightness between their shoulder and elbow. Such a manifestation indicates chronic damage to the tendon.
Diagnosis
In order to make an accurate diagnosis, the doctor not only collects an anamnesis, clarifies the circumstances of the injury, but also examines the injured limb, prescribes instrumental research methods to confirm or refute the diagnosis.
Each patient, if a rupture of the biceps is suspected, is assigned an x-ray. This method does not display soft tissue very well, but it helps to identify causes of elbow pain that are not caused by a muscle problem. But to determine the integrity of muscle tissue, the type of rupture is complete or partial, an MRI is performed. This examination allows you to see soft tissues, assess their condition.
The doctor may order an ultrasound. Special ultrasonic sensors evaluate the integrity of the distalmuscle tendon.
In most cases, the diagnosis of a rupture is obvious and beyond any doubt, even without instrumental research methods.
Features of treatment
The rupture treatment method is selected depending on its type. With partial injuries, conservative methods are prescribed. They are usually recommended for those who have low physical demands. With this method of treatment, the flexion force of the elbow joint is reduced by 30-50%. Supination suffers more.
Conservative treatment is performed for patients with low physical activity, in old age, in the presence of contraindications for surgical therapy.
The essence of therapy is reduced to the local application of cold in the first hours after the injury. Mandatory immobilization on a scarf bandage, lasting at least two weeks. Immobilization will provide rest to the limbs, relieve pain.
In other cases, surgery is performed for a ruptured biceps tendon.
Operation
Surgical intervention allows you to restore the anatomy, the strength of the flexion of the limb in the elbow joint, supination. After it, the contour of the shoulder is restored, the cosmetic defect is eliminated.
In order for surgical treatment to give the desired result, it is carried out on the first day after the rupture of the biceps. At later dates, irreversible changes occur in the biceps muscle and it is no longer possible to stretch it to its original length. In the later stages of the rupture, operations are performed, but the results in this case are worse.
Recently, surgeons have begun to use a minimally invasive method. It allows you to reduce the likelihood of damage to nerve endings, as well as to make a minimal incision, which is almost invisible.
As medical practice shows, no method of surgical intervention is safe and can lead to complications, including minimally invasive techniques. The most common is chronic pain in the elbow joint. In isolated cases, rotational movements are limited. Very rarely, a specific infection of the surgical site may occur.
Possible operations
The doctor can choose from several methods of fixing the muscle to the radius. Some surgeons prefer one incision, while others prefer two. Each method has its own characteristics.
Some doctors fix the muscle with sutures through artificially drilled holes in the bone. Sometimes metal implants are used to fix the tendon to the bone.
Inflammation may occur after surgery. To eliminate them, medicines of general and local action are selected. The drugs help not only relieve inflammation, but also reduce pain, which is especially important in the first days after an injury.
After a muscle rupture, athletes can return to sports no earlier than four months later. At this time, physiotherapy exercises are carried out, which helps to restore mobility, joint flexion strength.
