Getting old and crumbling down slowly

Dear Bloggers,

I recently injured my right arm and was told I had damaged a ligament on my bicep, known as a 'Popeye' muscle. I wish to have surgery to repair this, but have been told this isn't considered for older people, regardless of their physical condition. I am willing to pay for the treatment if necessary. I am a fit 48-year-old - I go to the gym once a week and try to stay healthy to care for my mental crashed wife.

I've damaged a ligament on my bicep, known as a 'Popeye' muscle It just snapped when I helped the son of our neighbors to get his car out that was stuck in the mud
This injury is clearly frustrating for me but it's not a reason to withdraw from your valuable regular exercise regime, which is so vital for the maintenance of good health - physical as well as mental.

Hopefully, a detailed explanation from my doctor will help me to regain some of my former drive and enthusiasm,
He said to me: Enabling you to remain as physically active as ever, particularly retaining your ability to cope with the demands of your dear wife.
The bicep muscle is in the front of the upper arm; contracting it allows the elbow to bend and the upper arm to lift.

The lower end of the muscle attaches to the bones of the forearm; at the upper end the muscle divides and is attached to two sites in front of the shoulder.
The muscles are attached to the bones by tendons, which are tough tissues. Repetitive activities can lead to pain - what we call tendinopathy.
The risk of tendinopathy increases with age, resulting in the sudden rupture of one of the tendons at the top of the muscle, in the shoulder. I had mine on the elbow side,
I suffered a sudden traumatic moment when pushing the car my hand slipped from the car and I fell over, It came with an immediate pop, with pain and swelling, then considerable bruising a day or so later.

The bicep muscle is in the front of the upper arm; contracting it allows elbow to bend and upper arm to lift
This will have resulted in a visible lump in the mid-upper arm, causing the classic 'Popeye' deformity. This never repairs itself so the appearance will not change, although it may shrink a bit in some people.

Athletes who play sports that require upper arm power may need to have immediate surgical repair, though this is exceptional.
In most people with this injury, the reduction in strength is of less significance than you might expect, and most will regain good function after the bruising and pain has settled down, despite the inevitable weakness.
Surprisingly, you lose only 25% of muscle strength - bear in mind that there is a second tendon at the muscle.

Because the rupture is usually due to a process of long-term degeneration, though surgical repair seems logical, it is not necessarily a good practical proposition. This is because rupture is often associated with a more significant elbow problem,
Statistically seen distal biceps injuries are more common among people in their fifties, but I typically see them in active individuals in their fourties. That might be a result of the population I belong to.

For readers unfamiliar with my description of the injury, let me explain what he sees and feels. A Popeye deformity occurs when the biceps tendon tears off the bone (the radius) in the forearm and allows the muscle to retract up the arm. The retraction allows the biceps muscle in the arm to look larger than normal. The hook test is a test where a physician tried to hook his or her finger around the biceps tendon in the front of the elbow. If the tendon has torn and retracted, there is no tendon to hook.

I think surgery is necessary in active individuals, whether they are in their thirties or fifties or sixties. It is certainly possible to have a good outcome without surgery, but the biggest complain is residual weakness. The weakness is more related to decreased supination than elbow flexion. Common complaints of patients who treated their distal biceps tendon rupture nonoperative include weakness with turning a screwdriver or a doorknob.

According to my physician it is already to late to get surgery. If physiotherapy might not work out he will send me to a Podotherapist who might be able to fix this. As surgery is not without risks and chances to catch a bacterial infection are up to 40%
Prior to that, physiotherapy, with a range of strengthening and mobility exercises, may prove helpful despite the ruptured tendon - it will help you regain much of your lost strength, even though the 'Popeye' appearance will not alter.

There is a lot more to learn yet, but as we have known for years... you are what you eat. To stay in shape is for most of us a battle.

The Old Sailor,


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