Q: I was working out last week and felt a pop in my left arm. It hurt some. Then I noticed a bump in my biceps muscle. The pain has improved, but I still have some weakness. I do not like the way it looks. I have been afraid to go back and work out. I would like to know if this bump can heal itself and what type of doctor I need to see.
A: A very common injury in people who work out with weights is an injury to the longhead of the biceps tendon. The biceps muscle near the shoulder has two heads; the “shorthead,” which attaches to the front of the shoulder, and the “longhead,” which attaches inside the shoulder joint. The longhead is the biceps tendon that usually tears, and in some patients the tendon retracts into the arm and one is left with a deformity that looks like “Popeye.” I recommend you see an orthopedic surgeon to confirm the diagnosis and make certain that no additional injuries have occurred around the shoulder. In many patients, when the longhead of the biceps tendon is injured they have associated problems with the rotator cuff tendon or subscapularis tendon of the shoulder. If the only injury is to the longhead of the biceps tendon, two treatment options exist. Some patients will choose to live with the deformity and mild weakness in both flexion of the elbow and rotation “supination” of the forearm. In the nonsurgically treated patients, a physical therapy program can be effective in decreasing the pain and restoring as close to normal function as possible. But the deformity of the muscle without surgery will be permanent. Surgery is an option for patients who are concerned about the appearance of the biceps muscle or obtaining maximal strength. The surgical procedure allows reattaching the biceps tendon to a portion of the humerus. Surgical results are usually quite good in terms of strength and appearance. Once again, I recommend you see an orthopedic surgeon as quickly as possible as the best results are derived from quick treatment.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship,
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Dr. Harlan Selesnick