Complete long head of biceps tear

[MC London]

Complete long head of biceps tear anyone playing without surgery who has a single handed backhand ?

I am 62, I had successful supraspinatus debridement surgery in July 2020. Did 12 months rehab, recommenced playing July 2021 and played a further 11 months without any issues until June 2022. I then started to experience anterior shoulder pain particularly when hitting high forehands and serves. I stopped playing after a few sessions in July 2022. I had an ultrasound and MRI scan which revealed long head of the biceps and distal subscapularis tendonosis. Since then over the past 9 months I have had regular weekly physiotherapy, dry needling, PRP, surgeon consultations and a few MRI's to update and monitor the progress. I was given the all clear to restart a few weeks ago. I started playing with light junior balls mostly in the service box just for a few minutes, twice a week. ie. strictly not pushing it. I played a few days ago and on scooping a low gentle forehand hitting within the service box the long head of my biceps completely ruptured i.e. the classic "pop eye" appearance which was reconfirmed with the surgeon. I had been playing just for a few minutes and warmed up the shoulder.

For an elder like myself it is not common to have long head of biceps repair tenodesis surgery in isolation as I have already had rotator cuff surgery and just carrying on without it typically does not affect ones strength. However tennis is perhaps unique where supination against resistance is common i.e. single handed topspin backhand. With a long head of the biceps complete tear, supination is seemingly the most affected.

Has anyone played with a complete long head of biceps tear with the rest of the shoulder being in ok shape without bicep muscle cramping and without pain ? If I did not play tennis I would leave "as is", it is not pretty but functional.

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Thanks

 

[Injured Again]

Ouch! Sorry to hear of your injury - you've got really good strokes. I can only give you my opinion - someone who hits the ball as well as you do and with as much living as you still have to do, I'd suggest the reconstructive surgery. If you're active and willing to do the PT, you'll still have a long time when you can play tennis to the extent of your capabilities after the repair.

Good luck!

 

[MC London]

Ouch! Sorry to hear of your injury - you've got really good strokes. I can only give you my opinion - someone who hits the ball as well as you do and with as much living as you still have to do, I'd suggest the reconstructive surgery. If you're active and willing to do the PT, you'll still have a long time when you can play tennis to the extent of your capabilities after the repair.

Good luck!

Thanks for your comments which sincerely appreciated, I think the same..... However.... in reality at least here in the U.K. a bit different. I had the MRI which confirmed isolated complete proximal long head of the biceps tendon tear - i.e. rest of the posterior shoulder i.e. supraspinatus tendon surgery nearly 3 years ago fully intact.

The surgeon and other opinions politely but firmly said not worth doing the repair surgery, citing 50% failure rate as it would be sub pectoral tenodesis and to get on with proper serious high quality physio. Playing future tennis with a reasonable technique and without muscle cramping/supination restrictions even with a one-handed topspin backhand should/will not be an issue.

Maybe different in the USA but on this side of the pond it was in theory "yes" we can surgically repair but in practice not at all keen other than conservative management for a spontaneous rupture of the proximal long head of the biceps tendon.

In the grand scheme of life, it's not the end of the world, let's see how I get on.

 

[Rosstour]

My Dad is Popeye now, and he waited too long to do anything about it so it's too late. But he has no pain and isn't lacking much power compared to before.

 

[ollinger]

Maybe different in the USA but on this side of the pond it was in theory "yes" we can surgically repair but in practice not at all keen other than conservative management for a spontaneous rupture of the proximal long head of the biceps tendon.

Not very different. Surgery often not recommended for this here as well. I know a surgeon who had this injury himself, never had it operated, still plays a pretty good doubles game.