How Are Shoulder Biceps Tears Treated
Surgery may be a choice for those who continue to experience symptoms after non-surgical treatments and have a cosmetic Popeye bicep muscle.
Surgery to reattach a long head tendon is quite safe, with few complications. It can return nearly all of your arm strength and function, and a re-tearing of the repaired tendon is uncommon. If you decide to have surgery, you will need to do flexibility and strengthening exercises to rehabilitate your shoulder. This can last for several months.
When Pain Warrants Evaluation By A Sports Medicine Doctor
Aside from the fact that being in pain, well…hurts, some sports injuries can can cause permanent damage if they’re not evaluated and treated properly. This means that it’s important to know when it’s time to do something about your pain.
“Muscles can strain, ligaments can sprain and bones can break,” Dr. Rand explains. “Most of the time, these are acute injuries that cause sharp pain, but, regardless of whether the pain comes on quick or slow, these types of injuries require evaluation and carefully planned treatment.”
When it’s a rupture, tear or break, it’s probably pretty obvious that you need to see a doctor but even muscle strains are best handled by a sports medicine doctor.
Acute Skeletal Muscle Injuries
The past few years the POLICEprinciple has generally been considered as being the best method to minimise swelling and relief pain within the first 24 to 48 hours. Although the different components of the RICE-principle have each shown their effectiveness in experimental studies, the use of the all-round concept is yet to be proved in randomised clinical trials. These methods focus on the acute management and do not really provide any information on the sub-acute and chronic stages of soft tissue healing. More recently Dubois and Esculier proposed two new acronyms to optimise soft tissue recovery: PEACEand LOVE.These two acronyms include the full range of soft tissue injury management from immediate care to subsequent management. It also highlights the importance of patient education and addressing the psychosocial factors involved that will aid recovery. It also highlights the potentially harmful effects of using anti-inflammatory medication for recovery. Read more about the Peace and Love principle in the management of soft tissue injuries here.
Evidence for early mobilisation
The active treatment needs to be built up gradually from isometric exercises to isotonic exercises. Only if those exercises can be performed without pain, isokinetic training should be started.
As muscle injuries generally recover well with conservative treating, surgical intervention is only to be considered in cases with very specific indications:
- Large intramuscular haematoma
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Fibularis Muscle And Tendon Injuries
If youve strained one of your fibularis tendons, the pain in your ankle will let you know something is wrong, but youll probably have a hard time identifying the fibularis as a source of the trouble. Thats because this injury tends to get overshadowed by a much more common and better-known cause of pain: a lateral ankle sprain.
In fact, the fibularis usually doesnt get injured in isolation. Typically the ankle is sprained as well. But when a fibularis muscle or tendon is involved, simply treating the sprained ligaments will not fully resolve the pain.
Image 1:
The fibularis longus and brevis act as a counterbalance to the posterior tibialis muscle, which I discussed in a previous article . Together, they are referred to as the stirrup muscles. Imagine sitting on a horse and pressing down on just one stirrupyou would be unstable and more likely to fall off. Likewise, if your fibularis and posterior tibialis muscles are not in balance, you are much more likely to fall and sprain your ankle. These structures are placed under stress whenever you walk on uneven ground, climb on rocks, go skiing, or run quickly from side to side as you might in a tennis or basketball game.
Image 2:
Investigating More Ways Of Repair

In another project, Andarawis-Puri and her colleagues are swapping injured tendons between regular healer and MRL mice models to see how the tendons heal when they are in the different systemic environments. In yet another, they are seeding cells from the tendons of normal healer mice models onto decellularized tendons from MRL mice models to see if the tendon matrix from the MRL tendon can reprogram the cells from the normal healer and prompt them to lay down matrix in a regenerative manner. If so, this may be a key step to advancing tissue engineering approaches for humans.
The question is, when tendon injuries do occur, can we promote some sort of effective repair? Andarawis-Puri says. That could be in conjunction with surgery to improve patient outcomes, or it could be instead of surgery. It would be great if we could just inject somethingsay, a cocktail of growth factorsthat would actually tell your cells how to lay down good matrix to ultimately produce scarless healing.
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Other Soft Tissue Injuries
Aside from strains and sprains, people can also bruise the tendons or ligaments, along with the surrounding tissue.
Bursitis is a type of inflammation that may feel like an injury to the tendon or ligament. Bursitis happens when bursae small, gel filled sacs that cushion the bones, tendons, and muscles near the joints become inflamed. This inflammation often happens because of overuse or extreme stress on the joint. Many people experience bursitis alongside tendinitis.
The treatments for ligament and tendon injuries are very similar.
For minor strains, sprains, inflammation, and other injuries, most doctors will recommend the RICE method:
- Rest the injured area and avoid putting weight on it.
- Ice the injury to reduce swelling and pain.
- Compress the injury with a compression garment or wrap to reduce swelling and promote healing.
- Elevate the injury above the height of the heart to ease pain and reduce swelling.
Over-the-counter nonsteroidal anti-inflammatory drugs may help with the pain. However, it is important not to use pain relievers as a way to ignore the pain and return to daily activities. Pain relievers do not cure the underlying condition, and putting too much weight on an injured tendon or joint can make the injury worse.
For more severe injuries, a person may need additional treatment. Some people find relief from physical therapy, especially if they suffer from chronic or overuse injuries.
What Are Achilles Tendon Injuries
The Achilles tendon is a fibrous band of tissue that links the muscles in your calf to your heel. The strength and flexibility of this tendon are important for jumping, running, and walking. Your Achilles tendon withstands a lot of stress and pressure during everyday activities, as well as during athletic and recreational play. If it becomes inflamed, swollen, and irritated, it is called tendonitis.
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Diagosing Tendon Or Ligament Tears And Ruptures
You should see a doctor immediately after tearing or rupturing a tendon or ligament. Swelling can affect the diagnosis of your injury.
To diagnose a tendon or ligament injury or rupture, your doctor will collect your medical history and perform an exam.
He or she will ask you questions such as:
- How and when did the injury happen?
- Did you hear a popping sound?
- How intense is the pain?
- Have you had any previous injuries to the knee?
Your doctor may order an x-ray or MRI to help confirm a diagnosis.
What Is Biceps Tendonitis
Even though tendons are tough, if you overuse them they can become sore and painful. This is caused by micro tears in the tendon and it is called tendonitis .
Tendonitis can occur because of repetitive motion. For instance, professional baseball players, swimmers, tennis players and golfers are at risk for tendonitis in their shoulders, arms and elbows. Tendonitis can also occur because of a sudden, serious load to the tendon.
You can get biceps tendonitis in the shoulder or at the elbow. It is unusual to have tendonitis in both places at the same time. In the shoulder, biceps tendonitis can occur at the same time as rotator cuff tendonitis as it is part of the rotator cuff complex.
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Im A Patient Whos Interested In Orthobiologic Treatment For My Injured Tendon How Can I Get My Doctor Involved Or Find A Stem Cell Doctor Near Me
Engage your physician, let them know the benefits of the unique Greyledge approach, and link them here.
Alternatively, you may be able to find a physician who is already utilizing Greyledge and is providing fully-customizable PRP and stem cell injection therapy near you. If youd like to get started with one of the most innovative orthobiologics companies in the field, find a Greyledge user today.
How Do Sprains Happen
Sprains usually happen when a person falls, twists, or is hit in a way that forces the body out of its normal position.
The most common type of sprain is a sprained ankle. About 25,000 people sprain an ankle every day. Think of a runner who goes over a curb and catches their foot, twisting the ankle or a baseball player who slides into a base and twists their knee.
Wrist and thumb sprains are also common, particularly in sports like skiing, where itâs not unusual to fall and land on an outstretched palm.
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Measurements Of Carpal Tunnel Pressure
Although large grip and pinch forces have been associated with an increased risk for developing carpal tunnel syndrome , the pathomechanics remain uncertain. A recent study has reported on the association between carpal tunnel hydrostatic pressures in vivo and controlled fingertip loading in man . That study showed an early increase in carpal tunnel hydrostatic pressure when light finger forces were exerted, followed by smaller pressure increase with additional loading. Though carpal tunnel hydrostatic pressure was proportional to finger tip force, it was essentially independent of wrist posture. The paper thus is not in agreement with earlier studies that showed that carpal tunnel pressure increased with both pronation and wrist flexion. One explanation could be that the Rempel study monitored hydrostatic pressures, whereas earlier studies monitored hydrostatic pressure and contact stress.
How Do Strains Happen

Athletes in contact sports, like football, hockey, and boxing, have the biggest chance of strains. Even in noncontact sports like tennis, golf, or rowing, doing the same motions over and over can lead to strains of the hand and forearm.
These injuries can happen when you work out at the gym, or they can happen at home or the workplace, especially if you do a lot of heavy lifting.
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Preventing Sprains And Strains
Some injuries, like a sudden stumble or whacking your knee on a dashboard during a car accident, arent always preventable. But others are. Take these precautions to protect your tendons and ligaments:
- Warm up before exercising. Do light aerobic activities to warm up your body for about 10 minutes before you start exercising. For example, walk a lap or two before you run around a track.
- Start out slowly and build gradually. This also helps warm up your muscles.
- Wear shoes that fit well and are made for the sport you are playing.
- Maintain a healthy weight.
- Vary your routine. Get a good balance of cardio exercise and strength training.
- Take a day off after an intense workout session or at least switch to a different activity. That can help you reduce your risk for overstressing the same ligaments and tendons.
- Listen to your body. If youre in pain or feeling tired, rest. Many injuries happen when your body is already overtired or stressed.
- Stretch. Most experts recommend stretching after exercise, when your body is warm and more pliable. Hold a stretch for no more than 10 to 20 seconds and do each stretch only once. Never bounce or stretch to the point of pain.
Are There Conditions That Put Me At Higher Risk For Musculoskeletal Pain
Some conditions can increase the risk of musculoskeletal pain, including:
- Arthritis: Arthritis causes chronic joint inflammation. Many people who have arthritis experience joint pain and stiffness.
- Fibromyalgia: Fibromyalgia is a chronic illness that causes all-over musculoskeletal pain and fatigue. Usually, people with fibromyalgia experience muscle, tendon or ligament pain.
- Tunnel syndromes: Some conditions cause nerve compression or pinched nerves. A few examples of these conditions include carpal tunnel syndrome, cubital tunnel syndrome and tarsal tunnel syndrome. Often, overuse injuries lead to these conditions.
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How Is Musculoskeletal Pain Diagnosed
Your healthcare provider starts a diagnosis by taking a thorough medical history. Your healthcare provider may ask you questions to determine:
- If you have other symptoms, such as a rash or fever.
- Whether your pain is acute or chronic.
- Which factors make pain worse or relieve it.
Then, your healthcare provider does a hands-on exam to look for the pains source. Your provider may touch or move the affected area.
Ligament Response To Alterations In Loading
Ligaments adapt to changes in physical loading given time and these adaptations have been studied extensively in several animal models. The most reliable animal studies utilize sham-operated controls rather than the contralateral extremity as a control, because the experimental procedure often causes abnormal loading of the uninvolved contralateral extremity. As summarized elsewhere the rabbit medial collateral ligament showed an approximately 50 % decrease in tensile stiffness after nine weeks of immobilization . Upon remobilization, the rabbit MCL stiffness had returned to normal values following nine weeks of remobilization, although its ultimate tensile strength still exhibited a 20% deficit at that time point. Such experiments underline the important point that soft tissues take longer than is generally appreciated by the lay person to adapt to changes in loading regimen.
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What Are The Symptoms Of Muscle And Tendon Injuries
Symptoms vary depending on the cause of the injury, but the most obvious one is pain, particularly during movement. This might be accompanied by swelling, bruising or muscle cramping. Severe tears may have a visible deformity, such as an indentation on the knee, or a displaced kneecap where the patellar tendon has torn below it. Depending on the injury, it may be difficult to bend or stretch the knee. Tendinitis can be accompanied by swelling and redness, difficulty in moving the knee, and pain that usually worsens during movement. Osgood Schlatters tends to be accompanied by pain and swelling below the knee during and after exercise.
When Should I Call A Healthcare Provider About My Tendons
Talk to a healthcare provider right away if you experience:
- Joint or muscle pain that happens suddenly.
- Pain that gets worse.
- Inability to lift or move part of your body as you usually do.
Without proper treatment, continued overuse of your tendons can lead to tendinosis. If you notice ongoing discomfort, talk to a provider about how to protect your tendons.
A note from Cleveland Clinic
Tendons connect your muscles to your bones. They let your bones move as your muscles tighten and relax. Conditions that affect your tendons include strains, tendinitis and tears, including rotator cuff tears and biceps tendon injuries. You can help keep your tendons healthy by monitoring your exercise habits and not pushing yourself past the point of pain. Be sure to see your healthcare provider if you have pain that doesnt go away or comes back.
Last reviewed by a Cleveland Clinic medical professional on 08/10/2021.
References
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What Are The Complications Of Achilles Tendon Injuries
Complications of an Achilles tendon injury may include:
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Pain, which can be severe
-
Difficulty walking or being active
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Deformation of your tendon area or heel bone
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Tendon rupture from reinjury
Other complications can be related to the treatments used for an Achilles tendon injury. For instance,
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Occasionally, cortisone injections can cause the tendon to tear
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Surgery can lead to pain and infection
Diagnostic Tests For Hand Sprains And Strains

Your NYU Langone doctor performs a physical examination, moving the hand to check for sensitivity and discomfort and to determine whether your range of motion is impaired. Your doctor may ask questions about your ability to perform tasks that involve the affected hand, your symptoms, and any prior hand injuries.
One or more of the following tests may also be recommended.
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Seek Help For A Stress Fracture
Another type of pain that requires evaluation is the pain that can signal you have a stress fracture a tiny crack in the surface of bone that forms as a result of overuse. At foot strike while running, if you feel a sharp pain in either your groin, the front of your shinbone or in your forefoot , it’s time to see a doctor.
“Stress fractures are more commonly seen in women than men, and, if you’re experiencing this type of pain, you should immediately stop activity and be evaluated by a doctor,” warns Dr. Rand. “A stress fracture in any bone can cause pain, but if a stress fracture in one of these areas completes to become a break, it can limit your activity and mobility for a long time.”
Tendon/ligament Tear And Rupture Treatments
Tendon and ligament tears or ruptures are painful injuries that require an experienced orthopaedic specialist to properly diagnose and treat them.
At UPMC Orthopaedic Care, we offer nonsurgical and surgical treatments for tendon and ligament tears and ruptures.
Choosing the best treatment option will depend on the extent of the tear or rupture, your desired activity level, and other factors.
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