Partial muscle or tendon tears around the elbow are common and most muscle tears and partial tendon tears can be managed without surgery. Where complete tears occur, especially related to the biceps and less frequently the triceps, surgical repair may be required. Imaging will help in determining the extent of the injury and MRI is very useful for this.
Where anaesthetic risk is high or patient demand is low, even full thickness tears can be managed non-operatively. Non-surgical treatment in some cases such as biceps tendon tears at the elbow can result in some functional deficits however. In general, early repair of complete tears is recommended in younger and more active people. It is important to note that tears of the biceps in the shoulder are not as concerning as they are in the elbow.
For partial thickness tendon tears and muscle belly tears, conservative management with pain relief and rehab is the first line. Occasionally an injection can help control pain if it is persistent. If despite these measures, disability persists or if the size of the tear increases, then surgery with repair of the tendon to the bone may be necessary. Surgery is often recommended at initial presentation with full thickness tears.
The surgery typically involves an open procedure where the bone is freshened, and the tendon retrieved and attached to the bone surface using an anchor or similar device. The exact technique and approach are dependent on the tendon involved. I will discuss this with you at your consultation. Occasionally in chronic tendon tears, grafting your tendon with either a bone bank tendon or a tendon from elsewhere in your body may be necessary.
Immobilisation in a splint or cast is often required to protect the repair in the early stages. Usually this means going home with a brace or cast with subsequent follow up with physio and occupational therapy to progress range. Once the tendon has healed (typically around 12 weeks), gradual loading can commence. The name of the game is to get range first and power will follow eventually. The road can be long and patience is required.
Physios: see our therapy guidelines for post-operative care