Need advice, bicep long head tendon tear.

[infidel007]

Hey guys. I've had problems with my right shoulder numerous times since I was a kid. I'm 39 now. I'm in great shape and in PT twice a week for a badly inflamed bicep tendon at the shoulder. About 3 months ago I was lifting an 80lb dumbbell off the floor when it "snapped". It's been a nightmare since. That same "snap" has happened 2 or 3 times during my freestyle wrestling and mma career and again at work. I'm a structural ironworker so there's no such thing as light duty. I'm going back to work Monday morning and I'm really worried I'm gonna tear the damn thing right in half. I've exhausted my savings, I have no choice but to go back to work. Typically I would spike up with test and deca to help with healing but I just came off a very successful (minus the injury) 16 week cycle.My pct is almost done but I don't feel like I should just jump right back on something...........it's too soon right? Thanks guys.

[Proximal]

My understanding is that the test is not going to make your tendons any stronger. In fact what happens is that your tendon strength cannot keep up with the very rapid increases in muscle strength while using, leading to tendon problems. HGH theoretically should improve healing time. If you are in PT already, follow the therapists advice, which aside from reducing the inflammation would assumably be, avoid anything that aggravates the injury. However, you are in a bind because of work. Just like the rotator cuff tendon, you are going to get friction of the long head with the scapula during any overhead work.

[infidel007]

Thanks for the advice Proximal. I don't use painkillers, so ibuprofen for pain and inflammation. Hgh would be great. I agree 100%. Just have to be so careful not to get beat. So much garbage out there. Anybody have any experience with Aflutop injections? I always steered clear of them, but what about a cortisone injection?

[Proximal]

I've personally done multiple cortisone injections and they have worked great. I've been working around a rotator cuff tear that sometimes involves the long head and have had (2) injections in the past.

BTW, the snapping sound doesn't necessarily have to be tearing or muscle damage - the long head sits in a "valley" (called the inter tubercular or bicipital groove) formed by two boney projections. The tendon can sometimes pop when it moves around there. An MRI would certainly be helpful to determine the extent of the damage so that you can tell what you have going on.

Tearing that thing and walking around with a "Popeye" arm would be a bummer - you're way too young. You often see old dudes in the gym with that (the long head is all balled up and it looks like your biceps has a peak). Best of luck.

[yettibecsuse]

Hey guys. I've had problems with my right shoulder numerous times since I was a kid. I'm 39 now. I'm in great shape and in PT twice a week for a badly inflamed bicep tendon at the shoulder. About 3 months ago I was lifting an 80lb dumbbell off the floor when it "snapped". It's been a nightmare since. That same "snap" has happened 2 or 3 times during my freestyle wrestling and mma career and again at work. I'm a structural ironworker so there's no such thing as light duty. I'm going back to work Monday morning and I'm really worried I'm gonna tear the damn thing right in half. I've exhausted my savings, I have no choice but to go back to work. Typically I would spike up with test and deca to help with healing but I just came off a very successful (minus the injury) 16 week cycle.My pct is almost done but I don't feel like I should just jump right back on something...........it's too soon right? Thanks guys.

I had mine reattached and now it is better than the right; i have had to cortisol injections they have been great and limit the pain in the joints

[infidel007]

Thanks guys, PT is actually progressing nicely and going back to work isn't so bad either! I'm definitely not 20 anymore but that's ok. I'm gonna make an appointment for an injection. Surgery will be my absolute last resort. My libg head tendon is inflamed, the Dr could feel it.

[SidVicious77]

Just FYI - cortisone injections will help with the pain for sure but can also make the tendon weaker.

[hellomycognomen]

Cortizone injections should be a last resort and only if pain is intolerable. If I were you I would skip the shot and instead just use over the counter anti inflammatory pills and let the recovery happen naturally. You can still continue to train if that is what you are worried about stopping. Lighten the load to half and do a slow and controlled HIT routine. The intensity will be there but you will no longer have the worry about working with heavy loads. Only the ego cares about the weight amount, to your muscles it makes no difference.

Below is Dorian Yates sharing his experience with cortizone injection:

[Proximal]

The above two points are valid - and yes cortisone is used after more conservative treatment (including NSAIDS) has not been helpful. With cortisone injections, it is generally too many repeated injections, injections with not enough time between, or stressing the tendon too quickly after the injection that generally causes the ruptures.

[infidel007]

I finally had an arthogram. It's MRI after the inject contrasting dye into the shoulder joint. I have another appointment in a couple weeks about what to do from here. What shocked me is the MRI was negative!!! No tears in the biceps tendons. Rotator cuff are good. So what the hell is going on? I'm thinking it must be neurological. Im pretty sure the doc is going to send me for an EMG. Every day I'm in pain, from my neck and traps my shoulder and down my bicep all the way to my forearm. Extremely discouraging. I swear when I take time off from training it gets worse. This sucks but I will continue to train. Pain or not, the gym is the only thing that keeps me out of trouble, keeps me sane!!

[Proximal]

. Every day I'm in pain, from my neck and traps my shoulder and down my bicep all the way to my forearm.

Well this could be a different problem entirely and depends upon what came first, the neck & traps or the shoulder region. Generally pain referral starts closer to the originally aggravated/injured area and then radiates from that point. So if you have a cervical (neck) issue, the pain then gradually radiates into the trap, shoulder, arm, forearm & hand.

However, with a shoulder issue, the mechanics of the movement are altered and that can screw up your traps and neck, so then the pain referral goes in the opposite direction.

The bicep & forearm pain can be coming from either.

A negative MRI doesn't automatically indicate that everything is perfect in that region either. What does your therapist think, what kind of progress have you made with them?

[infidel007]

My therapist said she could feel my bicep tendon is inflamed. I've had so many shoulder injuries over the years, I'm thinking there's probably multiple problems including nerve issues/damage. The pain definitely started in the shoulder and radiates out from there. It's just crazy how I felt great prior to the "snap" I felt in my right shoulder, and now I feel pain in so many places. My entire upper body is completely screwed up. Even my posture has been affected. My lower spine curves in ,pushing my belly out and pulling my shoulders back. IDK. EXTREMELY FRUSTRATED!!!!

[Proximal]

Your situation is more common than you would think, so don't feel badly. First off, the MRI was negative, which is a huge plus.

Because scapular movement plays such a major role in shoulder movement, any muscle that moves the scapula can get affected, subsequently tighten/spasm and cause even more issues, including: pain in those muscles themselves, messing with smooth shoulder movement and causing impingement (rotator cuff and possibly long head of the biceps) and also radiating pain away from the muscles down into the shoulder and arm, mimicking a shoulder issue.

Then on top of that the cervical and thoracic spine start to get affected, start to tighten/spasm and they too can refer pain down into the shoulder and arm.

Bottom line, is that this a mess and confusing because you don't really know what the primary culprit is and just how much everything else is contributing.

However, like I said to start - your MRI was negative, so you rule out structure damage of the shoulder - that's GREAT news. So now talk to your therapist and see if they can broaden their approach to include the scapular region, thoracic and cervical spine. Hell, maybe even seek out a chiropractor to make adjustments. Plus I've seen many chiropractors offer deep tissue massage as well, because they go so well together.

Question: as an iron-worker, how often are you doing overhead work and in particular, is your head and neck extended, that is you are looking upwards? The reason I ask, is this is a VERY common issue for cervical issues.

[infidel007]

Constantly looking up. So much so my neck gets tired. We try to work smarter instead of harder, but sometimes there's no avoiding it and overhead work is required. Yesterday Ihad a great workout with very little pain. Right now my shoulder and arm are screaming in pain from shoveling my driveway. But yeah, erecting steel is very unforgiving. I am constantly looking up because I work directly with the crane. Most of the time I'm either verbally or visually signaling the crane operator which requires me to keep my eyes on the load which is always over head. Thank you very much proximal, I really appreciate it!!!!!