Sprains, strains and tears: What can go wrong with upper arms

Having well-defined, muscular upper arms often is the goal of anyone seeking a fit, toned appearance. But there's more to these hardworking muscles than good looks. The biceps, the muscle in front of your arm, and triceps, the one at the back, do the heavy lifting when flexing or extending your arm and making twisting motions.

What can go wrong

Despite their strength, these muscles can be damaged through overuse or forceful injury, such as lifting a heavy object out of a truck bed or incorrectly using weights at the gym. Overuse can irritate the tendons, which connect muscles to bones, causing pain and inflammation. A forceful injury can tear or rupture the tendon.

Injuries to the upper arm muscles and tendons are most common in men 30–50, but women may also experience them.

If the tendon ruptures, you may feel a tearing sensation and actually hear a pop, usually around the elbow but sometimes at the shoulder. The muscle tends to ball up, forming a "Popeye" bulge that doesn't improve. It's usually accompanied by swelling, bruising, cramping and extreme pain, as well as loss of function.

The sooner a rupture is treated, the better the recovery since scar tissue can form and the arm muscles can begin to weaken or atrophy. Consult with an orthopedic surgeon to learn about both nonsurgical and surgical options.

Treating upper arm injuries

Some patients choose to forego surgery. However, pain, arm function and appearance (the Popeye bulge) won't improve over time.

If a tendon ruptures, the first line of treatment is to reattach it to the bone using sutures and anchors. This surgery is typically an outpatient procedure, with patients going home the same day.

Recovery may take three months or more. After surgery, the arm is immobilized by a splint with a 90-degree bend at the elbow and sling for several weeks, giving the repair time to heal.

Passive therapy, where someone moves your arm for you, is designed to help you regain range of motion and prevent the elbow from stiffening. You may want to continue using the sling for protection and comfort.

At four to five weeks post-op, active motion helps you regain strength. At that point, you'll be able to do light activities such as getting dressed, personal care and working at a computer. By three months, you'll be gradually rebuilding strength through increased activity.

Preventing injury

To prevent injury to your upper arm muscles and tendons, maintain overall strength, avoid overloading your arm muscles and be sure you're using proper technique when working with weights at home or the gym.

Douglas Bartels, M.D., is an orthopedic surgeon in Orthopedics and Sports Medicine in Eau Claire, Wisconsin.