Ace Physiotherapy and Sports in Singapore
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+65 81535374 -
ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
#08-03 Singapore 428766 -
Opening Hours
Mon to Fri: 08:00am - 8:00pm -
Opening Hours
Sat: 08:00am - 4:00pm
Sunday (By prior appointment)
Biceps Repair
Distal Biceps Avulsion Repair
Distal biceps tendon repair surgery is carried out to treat a complete rupture of the biceps tendon at the elbow (avulsion). The biceps brachii, commonly known as the biceps, is made up of two parts – the long head and the short head – which join together to form one muscle. The biceps is a powerful muscle responsible for elbow flexion and forearm supination (turning the palm upwards), providing significant strength and movement. It attaches superiorly to the rim of the shoulder socket and distally to the radial tuberosity at the end of the arm bone.
A distal rupture of the biceps tendon occurs at its insertion on the radial tuberosity. This injury may result from an acute event, such as violent trauma, or a chronic condition, such as tendon degeneration. The rupture causes the tendon to tear away from the bone, often creating a visible shortening of the biceps, commonly referred to as the “Popeye sign,” as the muscle retracts toward its proximal origin. Typical symptoms include hearing a distinct “snap” at the time of injury, followed by significant swelling, bruising, and a marked reduction in elbow flexion and supination strength.
Depending on your age, lifestyle, and functional demands, surgery may be performed to reattach the biceps tendon. Surgical repair is generally not recommended for elderly patients who do not require high levels of strength or arm function, but it is strongly advised for younger, athletic, or working populations. The procedure involves reattaching the torn tendon to the bone using bone anchors drilled into the radius, along with sutures that secure the muscle tendon in place. In some cases, a biceps tenodesis may be performed, where the tendon is attached to the brachialis muscle instead of the bone. This approach is usually considered when there has been a significant delay before surgery or when the expected outcome is more favourable.
Physiotherapy prior to Distal Bicep Avulsion Repair
Physiotherapy prior to distal biceps avulsion surgery can help to alleviate symptoms and assist in the management of your injury. Ace Physio Sports can also help prevent secondary problems that may arise from incorrect or abnormal movement patterns adopted to compensate for your injury. Our physiotherapists will provide effective rehabilitation and management strategies to help you continue using your arm functionally while creating a strong foundation for post-surgical rehabilitation.
- Pain management techniques
- Gentle range of movement exercises
- Strengthening of surrounding muscles
- Postural correction and movement retraining
- Education on activity modification to protect the injury
Symptoms following Distal Bicep Avulsion Repair
Following distal biceps avulsion repair surgery, your arm will be placed in a posterior splint for 1–2 weeks to limit movement and support the healing tendon. During this recovery phase, it is normal to experience a range of post-surgical symptoms.
- Pain around the surgical site
- Swelling and bruising around the elbow and forearm
- Stiffness and reduced range of motion
- Weakness in elbow flexion and forearm supination
- Visible scarring at the incision site
Physiotherapy following Distal Biceps Avulsion Repair
Following distal biceps avulsion repair, acephysiosports.com will carry out a thorough assessment of your arm and upper limb to identify any problems and weaknesses. Based on these findings, a tailored treatment programme will be designed in line with surgical protocols to ensure safe, accurate, and effective rehabilitation.
Weeks 1-3
Focus initially with acephysiosports.com will be on managing acute symptoms and minimising post-operative complications. Your arm will be supported at 90˚ in either a posterior splint or a hinged elbow brace, preventing any active movement while encouraging early mobilisation within the constraints of the hinged brace.
- Pain management strategies
- Swelling reduction techniques
- Gentle passive range of motion (within surgical limits)
- Education on brace care and safe movement
- Maintenance of shoulder, wrist, and hand mobility
- Core and lower limb exercises to maintain overall conditioning
Weeks 3-6
Your elbow brace will now be locked to 60˚ and you will be encouraged to increase the range of movement as tolerated. Each week, the brace will be adjusted, gradually reducing its fixed position to further improve mobility. At this stage, active movement of your arm can begin alongside light strengthening exercises. acephysiosports.com will continually assess your arm, monitor your surgical progress, and tailor treatment around your specific needs.
- Progressive range of motion exercises
- Initiation of active elbow flexion and extension (within limits)
- Gentle forearm supination and pronation work
- Light resistance band strengthening
- Shoulder and scapular stability exercises
- Functional movement retraining
Weeks 6-12
Following 6 weeks of physiotherapy with acephysiosports.com, you will have experienced a steady but significant increase in the movement and function of your arm. acephysiosports.com will continue to progress your rehabilitation to ensure that your mobility, strength, and overall function are consistently improving.
- Advanced range of motion exercises to restore full flexibility
- Progressive resistance strengthening for the biceps, triceps, and forearm
- Functional task-based exercises to simulate daily and work-related activities
- Proprioception and coordination training for upper limb control
- Sport or activity-specific rehabilitation (where required)
- Ongoing monitoring and adjustment of your programme to optimise recovery
Weeks 12-16
Following 12 weeks of physiotherapy, you will have discontinued the use of your sling and will be well on your way to recovery. You will be nearing full movement and will have noticed a significant increase in the strength of your arm. acephysiosports.com will continue to progress your rehabilitation to achieve the combined goals of full movement and a return to function by the end of 16 weeks.
- Full active range of motion exercises for elbow, shoulder, and forearm
- Advanced strengthening exercises for biceps, triceps, forearm, and shoulder stabilisers
- Functional and task-specific training to restore daily activities
- Plyometric and sport-specific exercises (if relevant)
- Manual therapy as required to optimise tissue mobility
- Education and strategies for injury prevention and long-term arm health
Weeks 16+
This final stage of rehabilitation is focused on achieving full movement, strength, endurance, and function through advanced exercises and techniques. acephysiosports.com is committed to returning you to your previous sporting or occupational ability and providing a long-term management programme to prevent future problems. Full recovery can take between 4–6 months, with acephysiosports.com fully dedicated to helping you achieve your maximum potential.
- High-level strengthening for biceps, triceps, forearm, and shoulder stabilisers
- Advanced range of motion and flexibility exercises
- Endurance and conditioning exercises for sustained functional performance
- Sport- or occupation-specific training for safe return to activity
- Plyometric and dynamic control exercises to enhance muscle coordination
- Manual therapy and soft tissue techniques as required
- Long-term injury prevention education and self-management strategies
Summary
Distal bicep avulsion is an uncommon injury where your bicep tendon tears off the bone (avulses) at its attachment on the radius. This can occur through repetitive trauma, overuse, or direct trauma. A surgical procedure is required to reattach the avulsed tendon back to the bone. Your bicep is a powerful elbow flexor and forearm supinator, so when injured, it results in a significant loss of movement, strength, and function. Physiotherapy is an essential component of rehabilitation following surgery to help you return to your previous level of function. acephysiosports.com will provide a comprehensive and extensive rehabilitation programme focused on your personal goals and a return to your previous functional ability. Call +65 81535374 for more information or to book an appointment, or visit acephysiosports.com to book online.
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