Cinderella wasn't referring to a torn bicep when they sang the 80's rock ballad, "Don't Know What You've Got 'Til It's Gone," but that song title is #truth when it comes to a ruptured biceps tendon. You don't give much thought to how valuable your bicep is in everyday movement until it's no longer attached to your forearm. In a fraction of a second, and with the sound of a gunshot, your arm goes from feeling strong and functional to weak and flaccid.



After getting over the disbelief, your mind moves to the reality of surgery and the recovery process. When done right, your recovery can return your arm to its previous strength and function. Done wrong, your recovery process can leave you with subpar strength, reduced range of motion, and a thick and ropey tendon layered in scar tissue.





Prevalence of Distal Biceps Tendon Ruptures



Distal biceps tendon ruptures occur in one to three out of every 100,000 patients each year, with middle-aged men making up most of the cases.



As hard as it is to believe, the first reported biceps reattachment took place in 1898! I wonder who drew the short straw for that surgeon to try out the new surgery.



Though it sucks when it happens, you can get back to lifting, playing, and posing in your underwear (if that's your thing), in a short period of time. A good surgeon, and a solid rehab and recovery program can get you close to the strength, endurance, and muscle size you had before you tore it.



Of course, this all hinges on your willingness to work hard during the recovery period.



As common as it is for people to tear their biceps tendon, there isn't much information on how to maximize recovery. So, I thought I'd put together an article to that does just that.



I'll start with a few frequently asked questions.



Frequently Asked Questions About Torn Bicep Tendons (Distal Biceps Tendon Ruptures)



Before I delve into the recovery strategies, let me answer some common questions. Chances are, you're reading this because you just tore your bicep (or you know someone who did) and need to know how to deal with it.



Do you have to get your biceps tendon reattached?



It’s possible to lift your arm and hold your spouse's hand without getting your tendon reattached. However, you probably won't be opening pickle jars or rock climbing up the same cliffs with the same confidence if you skip surgery.



Your bicep turns your hand out (supination) as well as helps lift your forearm and hand toward your shoulder (elbow flexion). A ruptured tendon reduces supination strength by 40-60%, and elbow flexion strength by 30%. While it isn't life-threatening, you'll find that it's inconvenient. The investment in surgery right away will be worth it.



I only have a partial tear. Should I still do surgery?



In many ways, a partial tear is worse. With part of the tendon still attached, you're more likely to experience pain when you use your arm, and you're more likely to end up tearing it down the road anyway.



The bigger issue is, if you wait to do surgery, you end up with fraying of the tendon, which makes it difficult for a surgeon to reattach it. If you opt for immediate surgery, your surgeon will cut the rest of the tendon and clean it all up before reattaching it, making it more likely you'll have a successful outcome.



If I have it reattached, what is the chance that I'll tear it again?



If your surgery goes well, and you follow a solid post-surgery plan, it isn't likely. Only 1.5% to 1.6% of patients re-rupture their biceps tendon.



How soon after a rupture should I have surgery?



As soon as possible. The longer you wait, the more your bicep retracts up your arm, and the more painful it will be to pull it back down. If you wait too long, it probably won't be worth it. Get into surgery in two weeks or less if possible. 



What can I do to heal and rebuild my strength and function as fast as possible?



Read on. That's what the rest of this article is all about.