Biceps Tear

[joshmeyer]

I have a patient who suffers pain in the antero -distal biceps region following a lifting accident. Initially all the signs pointed to a mm tear and i thus treated the problem locally. His strength has improved but he still gets a sharp pain durin ULTT1 with elbow extension and forearm supination. Cervical spine movements and palpation is normal. His other position of provocation is at full active forearm flexion (not passive). I have tried local deep trans. friction, total rest, neural glides cervical spine mobes as well as radial head mobes, ulna mobes and most forms of electrotherapy. Nothing has changed his ULTT1 or forearm flexion pain.
Please help me !!!!!!

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[sahs]

Has the patient had any diagnostic tests eg: ultrasound or MRI? If there is a lesion perhaps iontophoretic infiltration of cortisone and then recommence therapy again?

[perfphysio]

How long has passed since the incident. It sounds like you are on the right track with you treatment decisions. You mayy assist healing by using a taping technique to unload the bicepos. They may actually has a small tear at the bone-tendinous junction in which case it will take several months for the pain to subside. If they are labouring or working out with any real weight at the gym, you have to get them to stop! :-) rich