Distal biceps tendon tear more than likely leads to surgery

As if the Colts secondary has not been tormented by enough injuries this season, we recently learned that safety Bob Sanders will be out with a distal biceps tendon rupture at the elbow which will require season-ending surgery. The surgery was performed by the renowned orthopaedist Dr. James Andrews earlier this week.

The biceps muscle is an important muscle in the upper arm. The distal tendon of the biceps muscle transmits all of the forces of the muscle to the forearm at its insertion (radial or bicipital tuberosity), thereby contributing to an athlete's ability to forcefully flex the elbow as well as rotate their forearm in turning the palm upward (supination).

The distal biceps tendon can tear, preventing the transmission of forces from the muscle to the forearm bones. While it can happen from repetitive injury in athletes, it more commonly results from a single traumatic event in which the flexed elbow is resisted or even traumatically extended as in Sander's case. The event is usually accompanied by a "popping sensation" and sense of sharp tearing around the elbow crease.

Once a distal biceps tendon is ruptured, it unfortunately will not heal on its own. Rather, the tendon will continue to retract away from the bone and slide up the arm as the muscle contracts without resistance. Over time, the tendon will be come stiff and scarred as well. This loss of biceps muscle function results in a loss of elbow flexion (bending the elbow) and forearm rotation strength.

Usually the presentation of a distal biceps tendon is not subtle in the athlete. When compared to the normal arm, the tendon can no longer be palpated at the elbow flexion crease. Frequently, there is swelling and bruising around the elbow flexion crease.

The diagnosis can be made by taking a history from the patient and performing a physical exam. An MRI often can confirm a complete tear of the tendon as well as to assess any potential retraction of the tendon. Over the past few years, surgical techniques and implants have improved, which, when combined with people trying to stay more active, has led to an increasing number of distal bicep tendon repairs being performed.

In the past, 2 incisions were typically needed to repair the tendon whereas now 1 is often used. Patients are protected in a brace for the first 6 weeks after surgery after which they progressively work on strengthening exercises before returning to sports. The best results are achieved when surgery is done within three weeks of the initial injury.

H1N1 fears cause boom in natural medicine

New Brunswick's natural medicine industry is seeing a boost in popularity as people look for alternative ways to ward off the swine flu virus.

With more H1N1 vaccine clinics being cancelled and those clinics that are running facing queues that stretch for hours, people like Pam Temple are offering natural ways to stay healthy.

Temple, the owner of Healthy Start in Rothesay, said she has a steady stream of new customers coming through her doors. Almost all of those customers are looking for alternative ways to fight the swine flu.

"We have parents that are looking for immune boosters for their children that are under two years old up to senior citizens," Temple said.

"Everyone is concerned about getting their immunity built up."
Naturopath fielding more calls

Blossom Bitting, a naturopath in Dieppe, said she is swamped with calls about H1N1.

However, Bitting said she doesn't have all the answers people want to hear about natural ways to prevent the contraction of the H1N1 virus.

"Because the H1N1 virus is so new, we don't know of anything in the natural realm that is specific against it," Bitting said.

Bitting said there are many supplements that can help fight influenza generally, such as ginger tea, garlic, multivitamins and extra vitamin C.

Bitting said alternative medicines are best used in combination with conventional medicine to stay healthy this flu season.

"I think the combination is going to be stronger than one on its own," she said.