Blown Bicep: A (very) belated Tokyo 2020 post
PREFACE
I wrote this post way back in August at the tail end of the summer games. I was hoping to get this out in a timely manner, but life got busy prepping for baby, home renos, etc. Then our baby was born, and we have been living an out of body experience for the past month as new parents. Yesterday I opened up my blog for the first time in months and saw this sitting there, 95% complete, and now about 2 months too late. Oops! But I wasn’t going to let all that work go to waste! I suppose in the spirit of the 100 day count down to Beijing 2022, I present my very belated Tokyo 2020 post.
Sport climbing made its debut this summer at the Tokyo 2020 Olympics. My husband is an avid climber, so we would make a point of tuning in at breakfast to watch the lead climbing competition. One of the contenders from France, Bassa Mawem, had a promising start in the qualifying round, and just had to score well enough in lead to move on to finals.
That is when he reached for a hold, held on for a couple seconds, then immediately let go, gripping his bicep in pain. In the slow-mo replay, you can see his bicep recoil. There wasn’t a doubt in my mind, he had ruptured his biceps tendon and his Olympics were over.
I will start by saying that this is not a common injury, so fear not you crag-seekers and climbing gym goers. But for those of you who are curious to learn more about this injury, here is what you need to know.
As I have mentioned before in my pulley posts, a tendon attaches a muscle to bone, and most muscles have two tendons, one at each end of the muscle. The biceps is a bit strange, as it has two muscles (hence bi in biceps), each with its own tendon at the top by the shoulder, but they then fuse into one tendon down by the elbow. While it is possible to tear any of these tendons, Mawem tore the bottom (distal) one, which caused the muscle belly to curl up like a window shade when it completely ruptures. Lovely.
I will not subject you to a video of it happening, but I’m sure there’s a YouTube video out there showing it if you’re into that.
Why does this happen?
The reason why this is so rare is likely due to the fact that you need the perfect storm of preexisting conditions to increase your risk of injury.
There are some studies that suggest that there is an area around the distal biceps tendon that is hypovascular, meaning it doesn’t get much blood flow. This matters because regions with less blood flow tend to be slow healers when injured, which can mean increased degeneration and possibly at a greater risk for tearing.
When you turn your forearm into pronation, or when your palm is turned away from your face, you are also closing the boney space between your radius and ulna (the two forearm bones) which could pinch the biceps tendon where it attaches. If you happen to naturally have more pronounced boney protuberances in that area, which would further diminish the space between the radius and ulna, this pinching mechanism could be amplified.
An inflamed biceps tendon will become thicker, and if we think about the point above about having limited space, then a thickened biceps tendon will be more likely to be pinched in a pronated position. This could further aggravate the tendon, and due to the limited blood supply, hamper recovery and set you up for a tear or rupture. Things are really compounding now!
The use and improper administration of certain drugs have been linked to tendon ruptures. This is more frequently seen in the Achilles tendon and notably in older populations, but it is worth keeping in mind. Specifically, the class of antibiotic called fluoroquinolones, and localized corticosteroid injections have been studied and there appears to be an increased risk of tendon rupture, especially when both were taken together.
What can you do about it?
As you can see, there aren’t many controllable variables when it comes to minimizing your risk of biceps rupture, however, there is one thing that stands out. If you are dealing with distal biceps pain, get it treated! An inflamed tendon in an area with poor blood supply and the potential of being mechanically pinched means it could be easily aggravated, resulting in a long recovery period. It could become chronic, at which point your likelihood of a rupture goes up. Get it assessed and treated before it becomes a problem.
You can also strengthen other muscles to help out your biceps. Working on shoulder blade stability and back strength will go a long way to distribute the load from your biceps to other, larger structures, which means you are less likely to overuse and injure the biceps.
Typically, a biceps rupture requires surgery to pin down the tendon, followed by a period of time in a cast to immobilize it. Rehab should start as soon as your surgeon gives you the OK, so have a PT/chiro/RMT on standby. According to news outlets, Mawem has or will be going under the knife. I wish Mawem a speedy recovery and hopefully we will see him back and competing when the Olympics head to his home country of France in 2024.
EPILOGUE
Mawem continues to rehab from surgery. You can see some of his progress on Instagram where he shares an account with his brother who is also an Olympic climber. Time to test your French comprehension!
