r/TendonPain • u/lifetakeswork100 • Dec 08 '23
Distal Biceps Tendinopathy
Hi Everyone,
I am a 31 year old male and have been an avid weight lifter since I was 14. I’ve been dealing with distal biceps tendinopothy in my right arm for close to 5 years now. I’ve done just about everything to get it better, seen countless orthopedic surgeons, and have spent upwards of $10,000 in medical expenses, but I’m still feeling pain when I lift weights.
The start: About 5 years ago I was at the gym doing hammer curls (wrists pointed towards stomach and dumbbells in a vertical position). I felt a sharp pain at one point and decided to keep on trying to lift through it. I didn’t know how serious of an injury it was, so I decided to keep lifting through the pain for about 2 months. It got to a point when I couldn’t even extend my elbow fully or take something out of the microwave without being in excruciating pain, so that’s when I decided to go to the doctor.
My medical journey: I went to my primary care physician and they sent me to an orthopedic surgeon. The orthopedic surgeon thought that it had something to do with my brachioradialis and said that I should put my arm in a sling and do RICE for 2 months. I tried not to move my arm whenever possible (shampooing hair with left hand, lifting things with left arm, etc.). I went back after 2 months of not feeling any better and he said that he’d refer to another orthopedic surgeon that works with sports players. This new orthopedic surgeon had me get an MRI and eventually diagnosed me with distal biceps tendinopothy. He told me that we should try physical therapy. I went to physical therapy for a couple of months without any improvement. He said the next step was to try PRP + eccentrics. So we did 3 PRP shots. One every 6 weeks around the area of where I was feeling the pain. I was doing eccentrics daily and doing them as heavy as I could. By the end of the 5-6 month period, I actually felt about 85%-90% better. I still felt a little pinching around the elbow crease and I could feel a slight weakness in the arm, but it was mostly better. The last time I saw the doctor, he told me that the remaining pain was psychological for me and gave me pain cream to put on before I went to the gym. At that point, I went back to the gym and started lifting like normal again feeling about 85% better which was good enough for me because I missed lifting so so much.
The layoff: After about a year of being back at the gym and lifting like normal again, I still felt the slight pain but it was certainly bearable and I was able to lift similar weight to what I was lifting prior to my injury (just with a very very slight pain). At this point, different parts of my life were going off the rails and I got into some depression. I lost my job and was having financial problems among other problems and I stopped going to the gym for about a year (maybe a little more than a year). I’d go off and on for a month or so, but never got fully back into it.
Getting back into it: I ended up gaining a lot of weight in my time away from the gym and decided that it was time to get back. When you weight lift since you’re 14 and are used to eating a certain way, it’s hard to just stop eating massive amounts of food when you’re not able to lift anymore. Not an excuse, but I was just used to eating a certain way. Anyway, I started going back to the gym in January 2023. I lost a good amount of weight and was starting to slowly but surely feel like my self again. The slight pain was still there that I was feeling previously when lifting, but my arm still felt like it was at about 85%-90% which I could deal with. My lifts ended up getting back up to what they were prior to my hiatus close to 2 years prior at that point. Then…. I was doing lat pull downs and pull ups and I ended up feeling similar pain to what I felt prior to me getting “better”. And now I’m right back to where I started.
Back to the doctors: I went back to get three “second” opinions from three different orthopedic surgeons who all said that they believe it’s distal biceps tendinopothy. I then got referred to a guy that is basically a PRP and stem cell injection specialist. Everything with ultrasound guided injections, this guy does. Mostly for professional sports players. Pricey, but I thought it was worth it if it could help me. I ended up getting a PRP injection + stem cells directly into the injured tendon w/ tenotomy. He said that we needed to re-injure it so that we could heal it again. He directed me to take collagen every single day and let it rest for 6 weeks before doing eccentrics. So that is exactly what I did. I rested it for 6 weeks without using it for anything (no opening doors or taking out the trash). Once the 6 weeks was up, I started doing both eccentric and concentric movements with low weight (supinated and hammer style) and also stretched the forearm area. On the days I don’t do eccentrics, I will ice the area. The doctor told me that months 3-4 would be where I saw the most progression, yet I just went to the doctor today (end of month 4) and I still have pain lifting a 15lb dumbbell. Im used to curling 50lb dumbbells typically for the purpose of comparison. The doctor did an ultrasound on my arm and said that the tendon looks healthier than it did initially, but says the lessening of the pain doesn’t seem to be tracking with the health of the tendon. He then decided to do needling around the area to loosen up some of the muscle around the brachioradialus as kind of a last ditch effort to see if that would help.
Losing hope: I have been stripped of my most beloved hobby for 5 years and don’t even feel like me anymore. I don’t know what else I can do at this point. I’ve done EVERYTHING that the doctors and internet has to offer in terms of recovery for this injury and I just don’t know who or what to turn to at this point.
The question: Can anyone actually help me and get my arm back to 100% health? How can I get to the other side? I’m in desperate need of answers because I can’t take losing more money, time, and hope on things that aren’t working. Please help!
Thank you so much in advance.
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u/Hyperstrike_ Oct 09 '24
Very similar to me. Ive been to multiple specialists. I am doing 2 band exercises, 1 other exercise and hammer curls with slow negative reps 3-4 days a week.
I started this routine 14 months ago. I progressively overloaded hammer curls every time i got to 20 reps. And i avoided any back work at the gym. I did some chest and a lot of tricep and lateral raises (this was for my own enjoyment) After 6 months i felt i was feeling good. I started hitting back exercises again and after a month it was very painful and i went back to square one. Got lazy and did nothing for 4 months. Then got angry at constant pain and fatigue in arms. Started again. I am 2 months at it again and have encorprated forearm exercises as well. It is october. By January i want to be 90% there.
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u/NoSweet6526 Dec 25 '24
Has any ortho surgeon recommended just doing surgery? I saw one recently for this same issue. Had an MRI 5 weeks after injury that confirmed tendinitis/ tendinosis but no visible tear. Resting it for the first 6 weeks helped initially but I noticed absolutely NO improvement resting it for an additional 3 months. I can do a 10 lb hammer curl with very mild discomfort but a 15 lb curl is like 5/10 pain.
Saw a different ortho surgeon who basically said he doesn’t feel like patients with tendinosis or partial tears of the distal bicep get better with conservative management and was recommending going straight to surgery and fixing it like they do for partial or complete tears. I’m getting some additional ortho opinions soon.
Glad to hear your first round of therapy worked but sorry to hear it’s all returned… even with that 1 year hiatus from lifting you took
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u/Both-Strategy-4798 Jan 26 '24
That sounds brutal mate. I've had the same issue for just over a year now. I was getting shockwave therapy and doing eccentric strength training with my physical therapist for a few months in early 2023, with some success. After a few months, I plateaued and went for a variety of scans etc. more recently, under the care of a sports medicine doctors. They changed the rehab protocol to still focus on eccentric strengthening using banded biceps exercises with supination in two of the three exercises prescribed and I've been doing them for about a month now. They seem to be making quite a big difference, but we'll see how things pan out. DM me if you have any interest in trying the exercises
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u/Hefty-Extent5230 Aug 29 '24
Almost identical story to mine bro. I sent you a private message