Post Radial Head Excision Block

Hi all,

After a bit of advice.

I fell onto my left elbow in Nov 2013 which resulted in a shattered radial head and dislocation. After a CT reconstruction the surgeon concluded the radial head was in too many pieces for screws and to let the bone heal again so I had a radial head replacement with a metal head fitted. I was put in a fixed plaster cast for 2 wks post op (not sure this was the best course of action) and then I started exercising. Slowly I worked off the stiffness until it would no longer stretch and I felt a different kind of block (not a soft tissue block). I had lost about 45 degrees of extension and about 35 when closing my arm. In addition over the next year I developed pain at the site of the radial head.

So I went and saw a different consultant who suggested the radial head may be overpacking the elbow and also wearing the muscle next to it causing the pain. So just under 2 weeks ago I had a radial head excision. This time, I had the cast removed the day after the operation and have been using a brace to do exercises. Ive had a much quicker recovery than the previous op and have gained a bit of extra extension and flexion. I am now between 15 and 20 degrees off straight when doing the exercises. I don't feel any pain or block in the area of where the radial head would be or the incision above it anymore but the problem now seems to be at the bottom of the bicep. When trying to extend it I feel a pain and stretch on the bicep tendon.

I have read online about tendon contracture when there is an imbalance in the muscles and I guess as there was a bone block which stopped this tendon to be exercised and extended for a year it sounds like this could be the cause of the block at the moment.

Wondering if there is a Physiotherapist who may have come across this before or even anyone who could suggest some ideas of how I can loosen this tendon again?