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What is a rupture of the long head of biceps?



Rupture of the long head of biceps is when the tendon which connects the biceps muscle on the front of the upper arm with the shoulder blade tears completely. Physiotherapy can successfully treat symptoms of a rupture of the long head of biceps.


Soft tissue massage of biceps brachi applied by therapistAbove: Soft tissue massage of biceps brachi applied by therapist



How does a rupture of the long head of biceps occur?



A rupture of the long head of biceps can occur when the biceps muscle is contracted strongly. Strong contraction of the muscle can overstress the biceps tendon and cause it to break or rupture. This commonly occurs in middle-aged or older people who have a history of biceps tendinopathy. This causes an area of weakness within the biceps tendon which can rupture if forces are great enough.


What are the symptoms of a ruptured long head of biceps?



A rupture of the long head of biceps causes instant pain and a sensation of something suddenly snapping or tearing in the top of the upper arm. There is usually a bunching up of the muscle in the lower part of the upper arm resulting in a prominent lump called a ‘popeye deformity’. The biceps will also be significantly weakened and considerable bruising over the bicep is normally noticed shortly after the injury. Other symptoms may include:

What should I do if I have ruptured of my long head of biceps?



A rupture of the long head of biceps will not get better on its own. Therefore, if you have this injury, it is advised you go to accident and emergency immediately (i.e. on the same day as the injury). In the meantime you should rest and ice your shoulder to limit the amount of bleeding and swelling within and around the torn ends of the tendon. Ice should be applied to the injured site for 15–20 minutes every 1–2 hours. Ideally, this should be applied using a bag of frozen peas or crushed ice wrapped in a moist cloth or towel.

A rupture of the long head of biceps does not heal by itself. As a result it may be repaired surgically. The decision whether or not to perform surgery will depend on how much the injury is interfering with the functioning of your arm and your everyday life. If your arm functioning is not impaired, the tendon may not be repaired. In these cases you should be able to return to full activity following a short period of rehabilitation.


Physiotherapy for a ruptured long head of biceps.



Following surgery (or a period of rest if the decision is to conservatively manage your rupture) the assistance of a physiotherapist is essential to determine an appropriate treatment plan. This may involve soft tissue treatment such as massage and stretching, electrotherapy and the progression through a series of strengthening exercises. Other treatments include: In cases where the tendon is not repaired you should be able to return to full activity following a short period of rehabilitation. In those that are surgically repaired the period of rehabilitation will be slightly longer.


What shouldn’t I do if I have ruptured my long head of biceps?



Following a rupture of the long head of biceps you shouldn’t undertake activities which increase blood flow to the injured site and, therefore, bleeding and swelling to the area. These include hot showers, heat rubs, massage, the consumption of alcohol and excessive activity.

To arrange a physiotherapy assessment call Physio.co.uk on 0330 088 7800 or book online.


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