05/22/2025
This is the second injury of this type in a very short period of time! Watch out for your biceps folks!! 😳
Here is the skinny on this injury: When the distal biceps tendon tears—typically during a forceful eccentric load (think: catching a heavy weight or sudden pull like riding a buckin bronco)—patients often feel a sharp “pop,” followed by immediate pain, bruising, and loss of supination and flexion strength.
🧠 Now What?
In healthy, active individuals—especially those who lift, climb, or do manual labor—surgical repair is usually recommended to restore strength and function. Non-op is an option but typically reserved for low-demand patients due to significant loss in supination torque (~40%) and flexion strength (~30%). This is according to the Internet!
🛠️ Post-Op Rehab Timeline
▶️ Weeks 0–2: Immobilized in a hinged brace or splint, elbow at 90°, light hand/wrist mobility
▶️ Weeks 2–6: Gradual ROM (avoiding terminal extension), begin gentle isometrics
▶️ Weeks 6–12: Progress ROM, introduce light strengthening (no resisted supination yet)
▶️ Months 3–4: Begin resisted supination, functional upper body loading
▶️ Month 5+: Return to sport-specific or heavy lifting with full strength restoration expected by ~6 months
🏋️♂️ Key Considerations
• Protect the repair early—this tendon has a tendency to retract
• Supination strength is the last to come back—don’t rush it
• Manual therapy can assist with scar mobility and elbow ROM restoration
• Educate patients early about the timeline to prevent frustration
🔁 This patient will be back to full activity—but it’s a marathon, not a sprint.
