Hey Guys: About a year ago, I suffered a complete rupture of my distal bicep tendon while deadlifting (with shitty form). It was reattached 3 days later and after 6 weeks in a cast I started back in on my training. I’ve progressed back to multiple sets of pull ups and am now deadlifting about 70% of what I could do before the injury (no straps). My question is: Will the tendon be as strong or stronger than before it ruptured and, if so, how long does that take? Thanks very much.
Rob,
I am in the process of going through this right now (about 5.5 weeks post surgery). I’m not sure what the answer to your question is. I think it depends on your age, health, genetics, and the method used to repair the tendon. I’ve looked into this, and there are a number of different methods used to reattach the tendon. Some are stronger initially, but may not be as strong long term.
One thing that has frustrated me a lot is the reluctance of my orthopaedist in answering my questions. I’ve talked to him twice about that at follow-up visits, and still don’t know the details of my surgery. The most I’ve been able to get out of him is suture anchor and fiberwire. Arthrex manufactures the fiberwire (high density polyethylene braid) which is left in the tendon. They have a lot of literature about a “bio-tendonesis” screw, although I’m not sure if that was what my doc used. I am determined to try to extract this information from him this Friday, my next follow-up visit.
BTW, my injury also occurred while deadlifting. I had had pain on and off in the elbow of the injured arm for several weeks prior to the injury. I don’t know if this is related, but I suspect it is. I had previously done successful rack pulls at the weight I was lifting when the injury occurred, but it would have been a PR from the floor. Personally, I probably won’t go past about 80% of that weight again. I was nowhere near being competetive (just 300 lbs) anyway, so I’m not sure what the point would be. I’ll probably use straps for heavier deads in the future, and avoid any form of heavy lifting with supinated grip (it was the supinated arm that was injured).
Did your ortho doc give you any indication on what to expect long term?
One other thing I had intended to mention: Have you heard of an herb called cissus quadrangularis?
I’ve read studies that indicate it speeds healing of fractures. It is also apparently useful as a weight loss supplement. Some of the companies that sell it claim it helps healing of all “white tissue”, eg ligaments, tendons, cartilage, etc.
I’m taking it, and my recovery is going nicely. That certainly doesn’t mean that it is helping, however. If you are interested, google it and decide for yourself.
BTW, I intend to progress pretty slowly once I start lifting again. I want to give my tendons plenty of time to adapt to the weight, and intend to be religious about a deload every 3rd to 5th week (probably less often at first while the weights are still fairly light. I also intend to NOT compare myself to the rest of the guys on this forum. They’re animals, I tells ya!
Good God…you know distal head detachments are only like 3% of detached biceps? I know because I did it too last Feb. Im a year out, and doing cleans, deadlifts, snatches, curls, chins, etc…but no where near the weight i used to. I have other health issues and surgeries which is why Ill probably never push it that far.
As far as surgery my doctor asked me multiple times before “are you on steroids” and even post op while doped up “are you on steroids”…which is funny because Ive not only never done AAS, I also was not training for 3 years due to other surgeries and major health problems that were not figured out…so I went with the best doctor I could find through friends who seemed to know (as you guys know its a rush once you find out you gotta get surgery ASAP), and went with it.
I do wonder what type mine was and if it was the stronger version? I hope so…my doctor and physical therapist told me it should be stronger than it was before, but I hardly doubt Ill try cleaning 350 or deadlifting 600 for reps with this thing anymore. I was scared to death to try chins until about a month ago.
He cut me in the elbow crease on the inside about an inch, said he used his pinkie to find the tendon and pull it back down, then on the backside of my forum cut about 1-2" said they pulled it apart while they drilled the forearm and put the tendon through?
I know this, my bicep doesnt hurt as much as my elbow/tricep does now when I do stress it. My bicep is smaller than the other one despite training it, but the bicep never hurts only the backside of the forearm/elbow/tricep. An ortho I bumped into unrelated said its because of whatever they did to anchor it on the backside might have changed the dynamics of how the elbow and tricep work a teeny bit.
Never the less, good luck to both of you. I pounded BCAAs (still do), EFAs, and the list of regular standard protocol supplements post surgery.
Bluecollar,
From what I’ve read, the two incision procedure is where they drill through the radius and run the sutures through the hole to anchor the tendon in place while it heals. As I understand it, this attachement isn’t as strong initially, but should be fine in the long run. One potential complication of this surgery is calcification of the tendon. I think this is somewhat more likely with the technique where they drill through the bone, as there is a lot more bone debris, and it’s difficult to irrigate it all out. There is another technique with an Endo-Button (you can google it) which I think sometimes uses two incisions. It’s hard to find enough information on the internet, as a lot of the articles require you to purchase them. Maybe I ought to go to a medical library??
man…I have no idea…I just figured since I went to a pretty well known guy in DC who did alot of athletes and stuff, he would do it the most secure way…so far so good I guess, cant complain but Im not hitting it heavy like the old days and dont know if I ever will get there again. Hope the damn thing is secure!
at 5.5 weeks I was still in some bionic brace device, how are you doing?
As I understand it, some of the newer methods have a stronger initial anchor allowing faster return to motion. In any case, it takes at least 12 weeks for the tendon/bone interface to substantially re-grow.
I was in a cast for 1 week, a brace for two weeks, a sling for another week, and nothing since then. I started working on range of motion at about 3 weeks, and now have nearly complete ROM. I believe I am to start “strengthening” at week 6 (this Friday). “Strengthening” probably means curls with 1 pound. This is very rapid rehab compared with the more traditional anchor methods, which might have you in a brace until 8-10 weeks or so.
I saw my orthopaedist today, and finally got the full details of the procedure. Regarding the OP’s origianl question, I specifically asked how long it takes for the re-integration of tendon and bone to reach full strength. He said it takes as long as 18 months.
You said you’re at 70% of the weight you were lifting before at about 1 year, so that sounds about right. Good luck with your lifting. Check back in, and let us know how it’s going.
wow 18 months…well Im glad Im still taking it “easy” to some degree then…I moved from DC to LA and had to cut some rehab short, but they were like green light do whatever you want…I asked about heavy cleans, deadlifts, etc, they were like yea no problem (doc and PT)…but knowing they have no clue about olympic lifting or powerlifting, ive continued to be way careful…although I am starting to do more o-lifts, and my elbow gets sore where they attached it so I might back off…Im not at 18 months yet.
Once I wasnt a college athlete or coach anymore, medical care concerning docs or PTs truly understanding what my kind of “training” or “working out” is exactly, has been for monkey a$$…they do not get it, so I take their advice with a grain of salt.
Finding doctors who truly work with highly competitive athletes day in and day out, and understand the types of workouts guy on this website do, weight room wise, MMA wise, is not common.
Well, he said “up to 18 months”. You might already be “full strength” whatever that means.
As I understand it, tendons and ligaments will get stronger over time if you don’t overstress them. From what I’ve read, they don’t get their blood supply mainly from either the bone or the muscle, but rather from the surrounding tissue. Once a tendon is torn and moved by inches, it ruptures the blood supply from the surrounding tissue. After it’s re-attached, it takes months for it to re-establish the blood supply. Again, this is all “as I understand it from the reading I’ve done”. Regardless, I think it is wise to be cautious with regards to tendon and ligament injuries, and give them plenty of time to recover and strengthen.
Hey guys,
I tore my left bicep tendon off the bone about 2 1/2 years ago and had the reattachment surgery using the dissolving screw and rope method. Here was my experience.
Leading up to the injury I was about 240 lbs. (12-14% BF) and was deadlifting around the 600 lb. mark and power cleaning 300+. I tore it off tackling someone in a rugby game and had it reattched several weeks later.
Long story short I didn’t start lifting weights again in any fashion until 6 months post op. My therapists (I had three over the course of my rehab including Auburn University’s head sports therapist as well as Dr. Lemack’s world renown therapy team) heavily emphasized not starting into weights too early as this would lead to excessive scarring and long term would weaken my tendon. They wouldn’t even let me jog for the first 3 months.
I lost a lot of muscle (around 30+ lbs.) and started light 6 months post surgery. No deadlifting or power movements. I had a lot of pain from some nerve damage from the surgery as well which took many months to heal. After 1 year I began seriously lifting again and upping the intensity.
I am now 215 lb. @ ~7% BF and pushing the same poundages I used to. My arm feels great with little to no residual pain. It took about 1 1/2 years post op to have zero nerve pain.
The moral of the story is to take it easy and don’t rush it. You will get back to previous levels and probably surpass them with hard work if you let yourself properly heal. I have seen others with my same injury who started at roughly the same time have much poorer long term results by rushing getting back into weights too soon. Short term gain long term loss IMO.
I supplemented very hard with glucosamine and probiotics to try to get any advantage I could in growing my tendon back stronger as well. Obviously you can’t prove a negative and I don’t know how I would have done without them, but I took them and feel great now for what that is worth. Given they are relatively inexpensive it might be worth the investment.
I hope that helps and good luck coming back from this insanely frustrating injury. Psychologically it is tough, but take your time and you will be back stronger than ever.
I’ve had difficulty finding papers that discuss the rate of tendon-to-bone healing, or at least ones to which I could gain free access. Here is one
http://www.ejbjs.org/cgi/reprint/77/12/1858
Digging out the data, the tendon repairs were tested at 6 and 12 weeks, and compared with control animals. The results
6 weeks: about 500 N
12 weeks: about 800 N
control: about 2400 N
These data suggest an asymptotic healing rate, with initial fairly fast reintegration, followed by a long, slow strengthening of the interface. If anyone knows of a study with a more complete timeline (ie out through at least a year) I’d love to see it.
Hey guys:
I’ve been away from the site for quite a while and stumbled upon this old thread. As an update, it’s been about a year and a half since the surgery. Unlike Kilbapa, I was back in the gym on the same day as the surgery–on the bike and doing leg extensions. I was, however, very careful not to push things too fast with the arm when I got the cast off. After about 6 months I started doing deadlifts and pull up again. Now, about a year after that, I am not quite back to the same poundages I was in the deadlift(probably because I still have a lingering fear of popping it again) but I can do more pull ups than I have ever been able to in my life. I think long slow rehab is the way to go and that it probably takes more than a year to get back to square one–especially if you’re 48 and shining a chair with your ass all day like I am. I hope everyone is doing well. Take care -Rob
One thing I want to mention is that anyone [in the US] is entitled to access their medical files and operative report to get the details that Mathineer said he couldn’t wrangle out of his surgeon. I did so. My op report explained exactly what kind of anchors and sutures were placed in various locations in my shoulder. All kinds of details that surgeons wouldn’t normally share nor would patients know to ask. I found these files incredibly educational.
I am also taking the slow and steady recovery method. I have people tell me they were benching four to six weeks post-op. I decided to follow surgeon’s/PT’s orders and play it safe.