6 Months Since Bicep Surgery

Biceps brachii - Muscles of the Upper Extremity Visual Atlas, page 46

Hardly seems possible, but with the snow falling outside I realized that tomorrow marks 6 months since my bicep tenodesis surgery. Here is a short update on where I am.

I had the surgery after more than a year of physical therapy that provided little relief to the pain and limited mobility I was experiencing in my right arm. I am not sure how I injured it in the first place but I am willing to guess that there was a dumbbell bench press somewhere along the way that did not go right. I reached the point early last summer where I knew it was not going to get better and, in fact, I was finding it harder to use my right arm and having difficulty sleeping from the pain at night.

The surgery was done by Dr. James Rosneck of the sports medicine department at the Cleveland Clinic; it was done outpatient at the sports medicine facility. Previous posts talk about my progress during the first week, two weeks, month, etc. My main complaint after the surgery was the continuing discomfort. It was not until about a month ago that I really began to sense that the surgery was worth it. I am almost pain-free; every once in a while, I get a twinge when turning my arm a certain way. I have returned to lifting heavier weights. I am no longer feeling like the injury and subsequent repair are in any way impairing my ability to do my work–especially teaching my fitness classes. I am still careful, and in the coming months I expect the improvements to continue.

My words of advice to those considering this bicep repair surgery: recovery will take longer than you think. The timeline given to me before surgery was not so accurate (is it ever?); I was able to get back to work in a week (although limited) and was back in the gym a week later. In terms of feeling “back to normal,” however, it was more like 5 months. Consider the risks and the benefits and make the decision that fits for you and your doctor.

Three Months after Bicep Tendon Surgery

Dumbbells

Ah…. Time flies when you’re doing physical therapy! It’s been just over three months since my surgery and I’m happy to report that progress is happening.

Last week, I met with my surgeon virtually who was pleased with my progress and re-assured me that the pain and discomfort I sometimes get are nothing to be worried about. It will continue to improve. In terms of beginning to add weight to my therapy and my own workouts, he told me to follow the instruction of my physical therapist since she is on the front lines and knows how I am doing. He reminded me that the recovery from this surgery is a long one and that I’ll need to be patient (which is why I am his patient!).

At PT, we have noted that my mobility and flexibility have increased. I am feeling less discomfort (although the day after PT I can usually count on some aches). My therapist told me that we can begin to start adding heavier weights to my workouts/PT exercises; I’ll be going from 3 lbs. to 5 lbs., and eventually even more. The main thing for me to watch for is the form; if I start to do the exercise in a sloppy manner or see that I am compensating by using another muscle it is a sign to back down or stop. As a Personal Trainer, this will not be too difficult as these are the same things I check for with my clients regularly.

Was the surgery worth it? Jury is still out, but it certainly seems that if I continue on the current trajectory it will have been a good idea. Once I am able to strengthen the shoulder/arm muscles and carry out the kinds of activities that I have in the past without pain, we’ll have the answer for sure. In the meantime, I will continue with my exercises.

More news in a few months.

Four Weeks after Bicep Tendon Surgery

20120309 Physical Therapy Equipment

Yesterday marked four weeks since my Bicep Tenodesis. The picture above pretty much sums up where I am: physical therapy and lots of it.

I have PT exercises I do twice daily (10-15 minutes) and actually go in for therapy twice weekly. Up until last week, almost all of the exercises were assisted in some way, but most of the exercises now are under my own power. For instance, I do an exercise where I slide my hand up the wall; I used to employ my good arm to push it up and now I no longer do that. This is progress.

I have noticed that my mobility has increased as well. I’m not near 100% yet, but it is a vast improvement over the first few weeks. There are some exercises that my therapist introduced that when I started caused me a lot of discomfort and my range of motion was very limited. Little by little, the ROM has increased and the pain has subsided.

The one thing that has surprised me the most is just how sore I still am, and its a pretty constant companion at this point. Some of it is a result of the PT exercises and pushing myself. I suspect that some of it is that as much as I try not to lift anything over 1 lb. with my right arm, that gets violated pretty often. Nothing over 5 lbs. for sure, but I do find myself not being as careful as I should. I wonder if the PT folks know that this happens in general and therefore give patients an untenable restriction with the hope that we might limit ourselves just enough–kind of like putting a 70 mph speed limit on a highway knowing full well that no one will observe that, but hoping that at least we’ll go under 80! In any case, I’m using a fair amount of acetaminophen.

My PT folks tell me that my I’m on track. I know that I am impatient. I’d like to get back to running and biking, and eventually doing resistance exercises. It is pretty boring to just walk briskly, or get on the bikes at the gym. I will just have to stick it out.

Earlier in the week, my therapist asked me if I felt the surgery was worth it. Good question. I hope to know the answer over the next month or so.

One Week after Bicep Tendon Surgery

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It’s been a whole week since my surgery. Here’s the update!

This surgery has been a lot less difficult than I feared. Last year, when I had foot/leg surgery it ended up being a much bigger deal than I expected. I haven’t taken any painkillers since Sunday…which isn’t to say that I haven’t had pain. Rather, it is not severe enough to warrant taking something that has an addiction risk.

A few annoyances that I can live with: It is hard to find a comfortable way to sleep while wearing a sling so my sleep patterns are off. The support hose I have to wear to prevent blood clots are not the least bit attractive; not going to be wearing any shorts for another week. The sling and restricted mobility in my arm are an inconvenience, making it hard to brush teeth, eat, write, use a keyboard, etc. These are all things that will go away (God willing) in a week and, in the meantime, are not life altering.

I started PT on Monday and have been doing a number of exercises twice daily: pendulum circles, assisted lateral arm extensions, assisted forward arm extensions, assisted eccentric lateral rotations, assisted forearm extensions and hand-pumps. The “assisted” means that it is either supported by my arm or a prop like a table or cane. Not too taxing and I definitely can tell the difference; things are not nearly as stiff as they were. I will be going to PT twice weekly for the next five weeks.

The big news was that I went back to Personal Training today–virtually. Just one client, but it is a good way to get back into it. Tomorrow, I’ve got two clients and then–after clearance from my doctor–I should be able to start in-person training with some limitations next week. I still cannot lift anything heavier than a coffee cup with my right arm, so any demonstrating I do will have to be with my left arm. (My client today kept starting single-arm exercises and I had to reminder that she needed to use both arms; in other words, do as I say, not as I do!).

The other encouraging news is that I’ve communicated with a few other people who had the same surgery and who were really pleased with the results. The are working out, have rebuilt the muscle, and have no limitations. I don’t pretend that I’ll be there in a couple of months, but it is good to know that there don’t seem to be any long-term negative effects.

Next week, I’ll go back to some regular posts, but we’ll also have a 14-day update. Thanks for all the good wishes in the meantime!