On April 23, I fell to the ground when my distal biceps tendon tore away from it’s insertion point on the bone in my forearm. Read about it in Part 1. This is part 2, what happened after I got multiple MRIs and visited 3 different orthopedic surgeons.
Day 9 post injury: Meeting with Surgeon #3
Surgeon 3 provided me with similar information: The MRI image is poor because there is too much fluid in the area. It is impossible to see how much of the tendon is still attached to the bone. I decided to wait another week for the edema to recede and get another MRI.
Days 10-15: The mental battle continues
Waiting and wondering is awful. My meditation practice became difficult. My appetite dropped off significantly, but I continued to train around the injury. Intense leg training helped elevate my mood. I also spent extra time working on improving leg flexibility, which for me is a form of meditation. Of course, I continued to read hundreds of PubMed articles about tendon injuries, tendon repair, and the biological process of tendon healing. During this time, my sleep pattern got severely screwed up for reasons I don’t understand. I started waking up multiple times throughout the night. This foggy half-sleep was riddled with images of my arm in a cast.
Day 16: Second MRI
The radiologist’s report: “There is moderate distal biceps tendinosis with high-grade, partial-thickness tearing at its attachment to the radial tuberosity. There is proximal retraction of some of the torn fibers by up to 8.0 mm.”
Well, shit. Eight millimeters sounds like a mile to me. This means some of those fibers are simply too far away from the bone to ever scar back down. If I am lucky, they will scar down to the remaining tendon. Neither the surgeons, nor any of the radiologists can give me a percentage of tearing, so I have no clue how much tendon is really left.
I am faced with a decision.
Day 17: Decision
I decide against surgery. I will see what my body can do with this.
I mount a blitzkrieg offensive to put my body into healing mode. Some of my tactics during this period:
- Double my intake of collagen in the form of collagen hydrosylate.
- Make sure I get plenty of vitamin D. My preferred intake method: sunshine.
- Continue strength training, working around the injury. This includes any exercise I can do pain free, which surprisingly included light overhead press by day 20, and bench press by day 23.
- All upper body sets are changed to sets of 12 or more reps, which has been shown to stimulate connective tissue repair.
I do a 24 hour “water only” fast to stimulate autophagy. Despite my pre-injury daily caloric intake of 4000-5000 calories, this one day fast isn’t difficult or unpleasant. Inexplicably, my sleep problem vanishes as quickly as it had arrived.
Day 24: Most epic leg day ever
After continued research, I realized that the body must remain in growth mode in order to heal quickly. Nutrients from pre-workout and post work-out drinks coupled with the intense workouts improve circulation to the damaged tissues. With this in mind, I prepare for battle with a leg day from hell.
- Back squats: 4 x 6 x 315 pounds
- Ass to grass Front squats: 4 x 5 x 225 pounds
- Ass to grass Pistol squats: 3 x 10 each leg
- Hip Sled: 3 x 15 x 180 pounds
- Single leg standing leg curl 3 x 12 x 85 pounds
- Calve machine: 3 x 10 x 90 pounds
- Eccentric only dumbbell curls on the injured arm with 2.5 pound dumbbells. People in the gym think I have lost my marbles.
Day 26: Pain report
All pain is at the tendon insertion point on the radial tuberosity. I have no pain in the muscle or in the musculotendinous junction. I have learned how to avoid nearly all pain by avoiding pronation and letting my brachialis and radiobrachialis do the work. On occasion, when moving my arm quickly or forgetting I am injured, I accidentally activate the biceps. This gives me an immediate shot of pain, which is an intense burning sensation unlike any type of pain I’ve experienced in prior injuries. It is the sort of pain that is frightening. It is the sort of pain that yells, “Stop what the fuck you are doing immediately, dumbass. And go to your room.”
When I first wake up in the morning, I get dull pain at the tendon insertion. This goes away after about 15 minutes.
Day 27: Occlusion training
I start occlusion training on hammer curls with a 5 pound dumbbell on the injured arm. Occlusion training is essentially training with a tourniquet on your upper arm to restrict blood flow. People in the gym are now beginning to realize that I actually should get some mental help. (Occlusion training is risky business if you don’t know what you’re doing, so don’t try this without supervision by someone who knows their shit.) I researched this extensively and believe that it drives nourishment into tendon, which otherwise gets limited circulation. If you want to know more about this, email me.
Day 28: Slipped while stretching! Ouch! Oh shit…
While stretching my abs (doing a spinal extension stretch with both hands on the floor), I accidentally activated my biceps while shifting my weight onto the injured arm. This delivered a shot of pain to my arm on par with a moderate kick to the groin, which scared the shit out of me. I spent the rest of the day panicking about whether I had re-injured the tendon. Dull pain began to radiate from the insertion point into the musculotendinous junction, an area I have not yet had pain. Pain with supination returns after having been gone for 10 days. I am thoroughly freaked out and go to bed scared.
Stay tuned…Click here for Part 3. My Story Continues.
P.S. If you are reading this and you have suffered a distal biceps tendon tear, or you think you may have,
please leave a comment and ask me questions. I spent an insane amount of time searching for similar cases and spoke to people who opted to have the surgery. I also found two case reports of people who opted not to have the surgery. When you’re injured, you want answers. When you’re injured, you need a support network that is not just a bunch of people on forums citing the worst case scenario. The internet is not your friend when it comes to injuries. You need sound advice and you need to keep a clear head. I feel qualified to advise you on a few key facets of your situation.
- MRI results are not conclusive. An MRI cannot display accurately what percentage of tendon is still attached to the bone.
- MRI results can tell you how much retraction exists in the ruptured tendon fibers. This is the real information you need.
- You must act quickly. The damaged tendon will begin to scar quickly and there is a limited window that is optimal for surgery. Don’t wait. Get an MRI now and go see an orthopedic surgeon that has done at least 20 of these procedures.
- Reach out to me. I’m continuing to research this injury and I will share my knowledge.