Distal bicep tendon tear

simtech

simtech

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A week ago I tore my distal bicep tendon. Had an MRI this week and it’s a high grade tear with less that 5% fibers remaining. I’m scheduled for surgery Monday as the surgeon recommended repair. He said since I’m active and young(47) that I would benefit surgery. Now I’m waiting till Monday but researching and wondering if I should cnx it.

Anybody had this? What was your outcome? Anyone have it and not repair? How did that turn out?

And to keep it aviation I have/had a CFI initial checkride for early August that I’ll miss now. And my plane is in another state getting an annual and I can’t fly it. Boo.
 
A year or so ago I tore a bicep tendon reinstalling my 414 engine cowling. It hurt a lot when it happened but pain went away in a few days. I finally decided to see an orthopedic doctor after 3 weeks. Diagnosis: Rupture of right proximal biceps tendon.She said it was too late for surgery to do anything except for cosmetics. She said no limitations on any activity so I’ve pretty much forgotten about it. But I am more careful lifting my cowlings. However maybe the distal tendon is more important than the proximal one. I sure don’t know.
I reported it for my 2nd class medical, and the AME basically shrugged.
 
Sorry for your injury. A (total or near total) distal bicep tendon tear is unlikely to heal on its own. I wouldn't presume to advise you on what you should do, but would you fly an aircraft with a rudder cable that had only 5% of its wire strands intact?
 
Get the surgery. I’ve had triceps tendons reattached in both elbows - similar enough, I would think. A tear that major will not heal properly on its own. Surgery will get it properly back in place and set you up for much better function in the long run.

When you start physical therapy, do everything they tell you to do. Once you’re cleared to start PT, you need to work that arm, re-strengthen it and get range of motion back. Never miss a session, never miss a rep or a set. If the PT staff okays it, do more.

Exercise normally otherwise. Find workarounds that don’t involve the surgery arm, but that do work the other arm. You have to stay in shape. If your nutrition isn’t great, get it up to par. Eat for performance, and also to not gain fat. That arm needs lots of protein and hydration.

Don’t be stupid like I was and get careless because it feels pretty solid three weeks after surgery and lift something fairly heavy. The second repair will be much more painful and slower to heal. But it has stayed solid, I made it back to 100% and don’t have any impairment or restrictions on either arm.

I used red light therapy for the second one, and this is certainly anecdotal, but compared to the other arm, it healed faster and with less pain. Maybe it’s more emotion than fact, but I think it works.
 
I had a bicep tenodesis when my doc repaired of a massive rotator cuff tear. Shoulder surgery is the worst. Yours should be easier. I presume you have a window of opportunity for the repair. Don’t put it off for too long.
 
Stewartb said:
I had a bicep tenodesis when my doc repaired of a massive rotator cuff tear. Shoulder surgery is the worst. Yours should be easier. I presume you have a window of opportunity for the repair. Don’t put it off for too long.
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Yep there is a window and tomorrow is the day. I screwed up and watched a video of what’s about to happen. Ugh drilling through bone can’t feel good afterwords. Sigh…..I’ve heard shoulder work is hard on a person!
 
simtech said:
And I assume this should be a yawn for a second or third class when it’s all done?
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Yes. Had similar in my elbow. Had surgery done March of 24. AME didn't care neither did FAA on my Class II.
 
Surprisingly, bone cutting and drilling doesn’t hurt much. The soft tissue they move in order to get to bone? That’s what’ll hurt. Best wishes for a good result and speedy recovery!
 
Stewartb said:
Surprisingly, bone cutting and drilling doesn’t hurt much. The soft tissue they move in order to get to bone? That’s what’ll hurt. Best wishes for a good result and speedy recovery!
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Yeah I’m not looking forward to it. First surgery and hopefully last surgery in my life. Thank you!!
 
simtech, yes it's a yawn at the AMEs....(ed. 07/07/25): good luck, today....
 
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There is a significant difference in outcomes in the outcomes between proximal and distal tears. A distal tear, or tear at the elbow, usually results in some loss of function if not fixed. This is in contrast to a proximal tear (a tear at the shoulder), which often heals with minimal residual impairment on its own. Without giving you specific medical advice, well, if I had a distal tear, I would have it fixed, and I'm older than you!

See the AAOS online info at

orthoinfo.aaos.org

Biceps Tendon Tear at the Elbow - OrthoInfo - AAOS

Tears of the biceps tendon at the elbow are uncommon. They are most often caused by a sudden injury and tend to result in significant arm weakness. To return arm strength to near normal levels, surgery to repair the torn tendon is usually recommended.
orthoinfo.aaos.org orthoinfo.aaos.org
 
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