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Bicep rupture

The rupture of the long head of the biceps often involves its proximal portion. 

It is more common in people over 40 years old that tell about chronic pain due to the impingement syndrome. This leads to a chronic sufferance of the tendon both for its overload and degeneration. Its rupture occurs more often after an intense effort and it is associated in the elderly people to the sufferance of all the rotators cuff. 

Probably you suffered from a sudden, localised and violent pain, generally accompanied by a noise similar to that of an elastic breaking, and the insurgence of an anterior protuberance. Sometimes rupture can also be asymptomatic. 

Diagnosis is prevalently clinic. X-rays can be helpful in patients suffering from a chronic pain to the shoulder that is probably due to the injury of the rotators cuff. The treatment usually used when dealing with these injuries is conservative and passes through al the 5 phases of rehabilitation. An aesthetic deformity tends to remain after the rupture, but the complete flexion of the elbow and the recovery of strength is achievable anyway.

Surgical treatments for instability

Episodes of relapsing dislocation or chronic instability need to be evaluated to choose the surgical treatment more proper. Surgery can restore the control over the scapula-humeral articulation, improving the containing effect of the structures devoted to the static stability, such as the capsule and the glenoid labrum. Your orthopaedist will ask you how long ago the shoulder started giving you worries, in which direction it moves, which your lifestyle is and whether you play sports, evaluating at the same time the anatomic damages described by the CT scan or MRI. He will decide on the basis of this information the type of surgery that could be performed both in arthroscopy or open-pit.

After surgery pain will be quite intense, but painkillers and ice will be used to control it.

You will be discharged with a brace that will prevent you from using the superior limb and you will be asked to abide by a series of behaviours while at home.After, you will be able to start a rehabilitation path to recover as soon as possible all the normal functions of the limb.

Bicep rupture - Rehabilitation

It involves the proximal portion of the tendon that inserts on the glenoid and is more common in people aged over 40, who have a history of chronic pain from impingement syndrome. This leads to chronic suffering of the tendon from both over-use that degeneration.

The rupture occurs more often following an intense effort and is accompanied by intense pain, sudden and well localized, accompanied by a noise similar to a rubber band rupture.

The rehabilitation consists in a first phase of pain control through physical therapies (laser, tens, ultrasound, ice), periarticular massage and stretching; afterwards you can proceed to the recovery of passive and active range of motion of the shoulder and the elbow with targeted mobilization both in the pool and in the gym.

Reached the contralateral joint ROM, the rehabilitative treatment consists in the recovery of the strength of the muscles of the shoulder girdle, the shoulder external rotators (mainly supraspinatus), the intra-rotators (subscapularis), the deltoid, latissimus dorsi /bib and then triceps and biceps through the execution of isotonic exercises first with elastic of increasing intensity and after with the use of weights or ballast.

The therapeutic program ends with the recovery of sport specific gesture of catching and throwing and prevention of re-injury.

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