Distal biceps tendons can rupture during heavy lifting activities.

Symptoms of a tendon tear in this region include:

• Swelling in the front of the elbow
• Visible bruising in the elbow and forearm
• Weakness in bending of the elbow
• Weakness in twisting the forearm (supination)
• A bulge in the upper part of the arm created by the recoiled, shortened biceps muscle.

When is surgery appropriate?

Distal biceps tendon tears commonly occur in men in their 40s and when the tendon ruptures, a deformed high-riding biceps muscle can cause a loss of about 50% of elbow strength.

It is important therefore to seek treatment early if you notice these symptoms as surgical repair is most effective in the first 2 weeks.

After one month, the chances of not being able to stretch the tendon far enough and requiring a tendon graft become higher.

Following surgery, there is normally a 3 month recovery process involving a sling and physiotherapy that your surgeon will guide you through.

Some elbow conditions can be treated arthroscopically (where a surgeon can look inside the joint using a small cut with instruments the width of a pencil).

The benefit of arthroscopic surgery includes a quicker recovery as only small punctures through the skin are used to access the joint as opposed to formal, open incisions.

Elbow arthroscopy can be useful in diagnosis and treatment of arthritis, loose bodies in the joint, tennis elbow, stiffness and fractures.

After a physical examination and imaging, your surgeon may recommend arthroscopy for treatment of your elbow issue.

Arthroscopic elbow surgery is usually a day surgery procedure but is often associated with prolonged rehabilitation to avoid stiffness.

A physiotherapist is an important part of your post-operative rehabilitation.

Lateral epicondylitis is a painful condition that affects the muscles and tendons of the forearm.

It is commonly referred to as “tennis elbow” but rarely occurs as a result of tennis these days.

Symptoms of this condition include:

• Tenderness on the outer bony part of the elbow
• Morning stiffness of the elbow with persistent aching
• Soreness in the forearm
• Pain worse when grasping or holding an object
• The forearm tendons that attach to the outer aspect of the elbow may become inflamed and torn as result of repetitive over extension of the wrist and elbow.

When is surgery appropriate?

In most cases, the micro tears and inflammation settle down and heal with rest but in some recalcitrant cases surgery is required.

This involves repairing the torn extensor tendons after excising the degenerate segment and performing a tendon release.

Both result in reduced pain and increased grip strength.

A sling is required for comfort post operatively and physiotherapy also.