I recently completed a successful rehabilitation programme with a client who was recovering from a biceps tendon rupture. The injury was sustained at work and was surgically repaired. The programme was implemented to facilitate a return to pre-injury duties as a Mechanical Fitter.
The biceps brachii muscle is located in the upper arm and originates from the scapula, via two tendons. The distal biceps tendon crosses the elbow to attach the biceps brachii to the radius of the forearm. These attachments enable the bicep to perform elbow flexion and supination of the forearm. Injuries to tendons vary in nature and include gradual overuse or acute tears from lifting an excessively heavy object. In this case, the injury was sustained whilst performing a heavy lift.
The exercise rehabilitation programme focused on progressively exposing the tendon to higher forces and variable movement patterns to facilitate a return to pre-injury capacity. Due to the physically demanding nature of Mechanical Fitting, an emphasis was placed on work hardening to ensure conditioning was achieved to perform all aspects of the pre-injury role. This included lifting, pushing, pulling, carrying and pronation-supination of the forearm. The exercises were also performed at variable rates of contraction and incorporated isometric (static) interventions to further emphasise work-specific conditioning and to aid the rehabilitation of the tendon. Research has shown that strength training is beneficial for stimulating adaptations in both muscle and tendon and is beneficial for tendon pain.
The outcome of the programme was successful, as all the critical physical demands specific to Mechanical Fitting were achieved and a final medical certificate was issued. Two key reasons for the positive outcome were the high level of motivation and accountability for performing the gym-based programme. It’s personally rewarding when an outcome like this is achieved.
If you would like more information on elbow injuries or other rehabilitation programmes that Absolute Balance specialise in, please don’t hesitate to contact us at info@absolutebalance.com.au
Daniel D’Avoine BSc(ExerSc&Rehab)
Exercise Rehabilitation Team Leader – Workers Compensation Specialist
References:
Borms, D., Ackerman, I., Smets, P., Van den Berge, G., & Cools, A. (2017). Biceps disorder rehabilitation for the athlete: a continuum of moderate- to high-load exercises. American Journal of Sports Medicine, 45 (3), 642-650.
Rio, E., Kidgell, D., Moseley, L.G., Gaida, J., Docking, S., Purdam, C., & Cook, J. (2016). Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. British Journal of Sports Medicine, 50, 209-215.
Wentzell, M. (2018). Post-operative rehabilitation of a distal biceps brachii tendon reattachment in a weightlifter: a case report. The Journal of the Chiropractic Association, 62 (3), 193-201.