This is Part 4 in a series about torn biceps tendons. Start with part 1. It has been nearly 8 months since I tore mine. My confidence in the scarred tendon continues to grow. I’m now comfortable pushing to failure on most bicep exercises. Check out this video.
Scar Tissue Slowly Becoming “Tendon-Like”
The total healing time for an injured tendon can take over 12 months. What I have in my arm now is scar tissue that is acting as tendon tissue. It is relatively strong compared to 4 months post injury, but it is not “tendon strong”. Every time I perform a loaded eccentric movement, I am essentially teaching the fibrous scar tissue how to behave. Imagine a ball of cotton with fibers crossing over each other in every possible direction. This is a good analogy to what collagen matrix (scar tissue) looks like initially. During eccentric loading, the scar tissue fibers are pulled, which induces the collagen fibers to align in the direction of stress (in parallel as in the image below). During this process, the collagen matrix slowly organizes itself into a more rope like structure, gaining strength and elasticity. However, the scar tissue is physically different from the original tendon tissue, and the fibers will never look as parallel as the original. Source
It is unlikely that the new tissue will ever have the same strength and elasticity as the original tendon. I accept this fact with gratitude that I have already achieved nearly 100% function and strength. Also, I have learned to pay close attention to my movements with this arm and have eliminated some movements which I describe below. I spend a few minutes every morning stretching the biceps, which not only improves circulation, but also elasticity, and my own confidence in the repair. Source
What I still can’t do
Here are a few activities that I will still not perform due to an internal sense of caution. Anyone who has torn a tendon knows what this “sense” feels like. It is part fear and part nausea inducing discomfort that tells the nervous system to shut down the arm when risk is perceived. Obeying this feeling is the single most important key to recovery.
- Preacher curls of any weight. They just feel wrong, even at light weight.
- Deadlift with a mixed grip. The loaded bicep in full extension freaks me out. Now I deadlift with double overhand grip.
- Gymnast rings moves that put my shoulder in extension. I can do dips on rings, no problem. I can even to muscle ups. But the moment I put my fully extended arm into external shoulder rotation, my central nervous system says it’s a “no go”. I hope to return to the rings with the same vigor as before, but it is clearly not time.
Additional Strategies I Have Used to Speed Recovery
In addition to the supplements mentioned in the prior articles about this injury, I have seen several bodyworkers including a Rolfer, a deep tissue massage therapist, and a trusted chiropractor. Acute injuries cause imbalances in the surrounding tissues. This is because other muscles and connective tissues are assigned tasks normally performed by the damaged ones. Overuse injuries that develop in adjacent areas of the body can persist for months unless actively treated with proper body work. This was the case for me. My brachioradialis muscle assumed the job of flexing my arm. The muscles of my forearm began to work overtime due to the lack of supination normally provided by my biceps. I developed trigger points in the brachioradialis as well as tendon irritation at the medial epicondyle, (the bony protrusion on the inside of the elbow). These minor injuries are side effects of the larger problem, but simply did not go away until I got some professional help.
I don’t take any NSAIDs, and have instead begun a regimen of self massage, which has the added benefit of keeping the rest of my body working efficiently. NSAIDs have a laundry list of nasty side effects, including slowing injury recovery.
I continue to train 6 days a week, eat a rock solid clean diet, avoid alcohol and nicotine, and sleep at least 8 hours per night. I drink a gallon of water per day, keep my stress levels in check, and meditate daily.
Hopefully, the next update will include a video of me back on the rings!