eMedicine Specialties > Physical Medicine and Rehabilitation > Upper Limb Musculoskeletal Conditions

Biceps Rupture: Follow-up

Author: Gary L Branch, DO, Mid-Michigan Orthopedics, Staff Physician, Memorial Healthcare Center.
Coauthor(s): J Michael Wieting, DO, MEd, Professor of Physical Medicine and Rehabilitation, Professor of Osteopathic Principles and Practices, Director of Sports Medicine, Associate Director of Physician Assistant Training Program, Department of Osteopathic Principles and Practice, Lincoln Memorial University-DeBusk College of Osteopathic Medicine
Contributor Information and Disclosures

Updated: Sep 18, 2009

Follow-up

Further Inpatient Care

  • Patients with biceps rupture, especially those who have been hospitalized for repair, rarely need inpatient rehabilitation.
  • Without adequate social support, the presence of other functional impairments or medical comorbidities may necessitate admission for compensatory strategies and/or adaptive equipment training.
  • Following admission, these patients should progress much like their counterparts with outpatient or in-home therapy.

Further Outpatient Care

  • Patients with biceps rupture, whether treated conservatively or with surgical repair, frequently are referred to outpatient facilities for physical or occupational therapy. (See Occupational Therapy.)

Deterrence

  • The pathophysiology of biceps rupture often is intimately related to chronic irritation, inflammation, and impingement; therefore, patients can best prevent ruptures by avoiding repetitive maneuvers and activities that predispose to tendinitis, bursitis, and rotator cuff injuries.7,8
  • The avoidance of falls in which direct trauma to the muscle or tendon occurs and the reduction of incidents of rapid, heavy loading of the muscle (especially with the elbow flexed and the forearm supinated) also may be helpful in decreasing the likelihood of rupture.

Complications

  • Possible surgical complications
  • Contractures due to excessive immobilization
  • Heterotopic ossification23

Prognosis

  • The overall prognosis for biceps tendon ruptures is good for surgical repair and for conservative management. Both approaches generally result in adequate functional return to the performance of ADL, as well as to most vocational and recreational pursuits.
  • Strength deficits existing before and after repair vary.
  • Factors such as comorbid disorders, concomitant injuries, age, and time since rupture may affect eventual functional level outcomes.

Patient Education

  • Educate patients on the importance of stretching in preparation for athletic or exertional activities and on the need to provide proper care of resultant injuries.
  • Warn patients that long-term or frequent steroid injections may weaken local tendons in the region of the injection.

Miscellaneous

Medicolegal Pitfalls

  • Few medical/legal issues surround biceps rupture. Diagnosis usually is apparent on physical examination, and when there is doubt, the diagnosis can readily be confirmed by MRI. Significant permanent disability rarely results.
    • Failure to exercise caution when evaluating or treating persons with upper limb injuries, pain symptoms, or functional impairments who require maximum strength and/or motion for vocational pursuits
    • Failure to diagnose or treat rupture of the biceps adequately in this setting - This may lead to lost wages, disability claims, and unemployment.
 


More on Biceps Rupture

Overview: Biceps Rupture
Differential Diagnoses & Workup: Biceps Rupture
Treatment & Medication: Biceps Rupture
Follow-up: Biceps Rupture
Multimedia: Biceps Rupture
References
Further Reading
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References

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Keywords

biceps rupture, biceps, biceps tendon, biceps muscle, biceps brachii, tendon rupture, ruptured tendon, tendon ruptures, biceps tendon rupture, bicep tendon rupture, bicep rupture, ruptured bicep, ruptured biceps, ruptured biceps tendon, torn biceps, torn bicep, biceps tear, bicep tear, torn bicep tendon, torn biceps tendon, rotator cuff, rotator cuff tear, tendinopathy, tendinitis, tendonitis, biceps tendinitis, biceps tendonitis, bicipital tendinitis, bicipital tendonitis

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Contributor Information and Disclosures

Author

Gary L Branch, DO, Mid-Michigan Orthopedics, Staff Physician, Memorial Healthcare Center.
Gary L Branch, DO is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Osteopathic College of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

Coauthor(s)

J Michael Wieting, DO, MEd, Professor of Physical Medicine and Rehabilitation, Professor of Osteopathic Principles and Practices, Director of Sports Medicine, Associate Director of Physician Assistant Training Program, Department of Osteopathic Principles and Practice, Lincoln Memorial University-DeBusk College of Osteopathic Medicine
J Michael Wieting, DO, MEd is a member of the following medical societies: American Academy of Osteopathy, American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Forensic Examiners, American College of Sports Medicine, American Osteopathic Association, American Osteopathic College of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, and International Society of Physical and Rehabilitation Medicine
Disclosure: Nothing to disclose.

Medical Editor

Robert J Kaplan, MD, James E Van Zandt VA Medical Center, Staff Physician, Department of Rehabilitation Medicine
Robert J Kaplan, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Patrick M Foye, MD, FAAPMR, FAAEM, Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Patrick M Foye, MD, FAAPMR, FAAEM is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society
Disclosure: Nothing to disclose.

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Robert H Meier III, MD, Director, Amputee Services of America; Active Medical Staff, Presbyterian/St Luke's Hospital, Spalding Rehabilitation Hospital, Select Specialty Hospital; Consulting Staff, Kindred Hospital
Robert H Meier III, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and Association of Academic Physiatrists
Disclosure: Nothing to disclose.

 
 
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