Distal Biceps Treatment Options

Nonoperative treatment may be considered for older patients, those with low functional demands, or those who can tolerate a loss in forearm rotational strength. This approach typically involves the following:

• Activity Modification: Initially, avoiding activities that cause pain or could worsen the injury can help promote healing. This could include avoiding heavy lifting and certain movements, such as supination (rotating the forearm to turn the palm up) and elbow flexion.
• Physical Therapy: After the initial healing phase, physical therapy can be initiated to restore range of motion and gradually strengthen the arm. This may include stretching exercises to improve flexibility and prevent stiffness, and strengthening exercises to improve muscle strength and endurance.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to help manage pain and inflammation in the early phase of the injury.

Surgical treatment is often recommended for younger, active patients and those who require full strength and function of their arm. Several surgical techniques can be used, depending on the specifics of the rupture, the surgeon’s experience, and the patient’s individual needs. In all cases, an incision is made on the front of the elbow near the crease, the torn tendon is found, and reattached to the radius bone using special anchors or suture material. In some instances, a second incision could be made on the back of the elbow as well. In very rare cases, or cases where the tendon has been torn for a long time, a graft may need to be used to allow the tendon to be reattached in the appropriate position.

Recovery following surgical repair of a distal biceps rupture can be a lengthy process. Immediately after surgery, the arm is typically immobilized in a splint or brace for 1 to 2 weeks. Then, under the guidance of a physical therapist, the patient gradually starts a rehabilitation program, starting with gentle range of motion exercises and progressively adding strengthening exercises.

Full recovery can take several months, and the patient may be restricted from heavy lifting and vigorous activities for up to 6 months. A successful surgical repair and rehabilitation can restore nearly all strength and function in the arm.