Biceps Recovery - Joe Grossi

Popcorn. “POP POP POP!”. That’s how I first described the sensation of my right distal biceps tearing from the bone as the tendon ruptured. Certainly not the worst injury in the sport of strongman, but it was my first injury that required surgical intervention. In strongman, biceps tears are among the most common injury next to the back, hip, shoulders, and knees.

On the audio, you could make out the faint noise of what sounds like cloth tearing. I was experimenting with a new technique of Axle continental cleans where I attempted a switch grip hang clean. But I failed to make contact with my hips… my brain thought the weight was going UP but in fact, gravity was pulling the weight down. No amount of “biceps health” work would have saved it. I didn’t feel much pain (maybe a 2/10 pain level), but after witnessing dozens of biceps tears before in the sport of Strongman, I knew well what happened. I pulled off my elbow sleeves, and sure enough...

My biceps didn’t look too deformed or rolled up very high. I thought it was perhaps a partial tear at first. I could still flex it a little. A friend of mine suggested trying the “hook test”. This is a simple test any strength athlete should know come the occasion. Simply raise your injured arm at a 90-degree angle in front of you with your palm facing you. Make a “hook” with your opposite hand’s index finger, and try to “hook” the tendon in your inner elbow. If you can’t find the tendon, it’s a full tear and will require surgery for reattachment. Surgery is optional, however. If you do not have the biceps tendon reattached, you will lose roughly 10-20% of your supination strength (very noticeable on twisting something like a screwdriver, or a salt grinder). Being relatively young and an active strength athlete, reattachment was the only option for me.

Immediately after the tear, you should take some voodoo floss and compression-wrap from the shoulder down towards the elbow to keep the bicep from rolling up any higher. I learned you do NOT want to go to the emergency room (unless you’re experiencing symptoms outside the norm), and should skip urgent care and any other regular doctor if you can. This can save a lot of money and time. Some insurances require a referral, but my United Healthcare insurance did not. 

The first call I made was the next morning to an orthopedics office recommended to me by a friend who had experienced three biceps tears in his time. The orthopedic surgeon I met with had me try the hook test and a couple of other simple tests but could tell instantly it was a full tear. He put me in a sling and scheduled a surgery for 6 days later. Waiting for surgery any longer than that could result in scar tissue build up and more retraction of the tendon in the arm, making for a more difficult surgery.

Mentally, waiting for the 6 days to pass until the surgery was the worst part. I couldn’t do anything, and my wife was frustrated by my inability to do my normal chores and help around the house since I’m right hand dominant and couldn’t use my right arm. Depression hit hard. My weight started plummeting, from 260 lbs down to mid 240s despite my diet calorie level remaining the same. The body can take some interesting, drastic measures when it knows it’s hurt. Once surgery took place, and I knew healing was underway, I mentally felt a thousand times better!

Healing takes roughly 3 months, and it would be 6 months before being able to push it hard. But I needed a training plan. Failure to plan is planning to fail. So I began working on a program.

I was back in the gym just 6 days after the surgery. I could still train my legs and my left arm. Doctor suggested I wait longer, but my first session back in the gym looked like this:

Leg Extensions 5x15
Seated Leg Curl 5x15
Seated Calf Raise 3x15
Hyperextension 5x15
Ab Crunch Machine 5x12

As you can see, lots of volume which means low load. Having not trained for 11-12 days, stitches still in, and the body trying to heal itself, going heavy right off would be ill-advised. The initial plan of action would be lots of machine work so as to not risk moving the freshly repaired arm.

I hadn’t used a commercial gym in nearly 5 years, but it was time to suck it up. There would be no extensive strongman training in the near future, but this didn’t mean I couldn’t use the time to heal nagging injuries and build up muscle mass in other areas with a hypertrophy/bodybuilding phase! There’s more than one kind of progress. You just have to realign your goals.

For the first 8 weeks, the plan looked roughly like what follows. Not every exercise was every week, but this was the split and roughly the exercise selection I picked from.

Some people asked me if I was worried that training the “good” side would cause an imbalance since I was unable to train the injured side. My response was “I’d rather have 1 weak side than 2 weak sides”. But in fact, it’s commonly found that training one side has a systematic effect that prevents atrophy in the opposing side as the body tries to maintain a balance. Also, I found that “visualizing” the injured side being exercised during the unilateral movements of my good side would help with awareness and activation of the injured side (basically visualize your unilateral exercises in your mind as bilateral exercises).

*All Upper body work done with Left (good arm) side only (SA = Single Arm)

In the first couple of months you need to be extremely careful. If you need to load plates, you may want to have someone nearby that can assist you. I found I could load plates to about chest level, but loading something like the SSB Squat, or unloading plates from a sled/yoke required assistance. I’m certainly in debt to several of my training partners for their help.

Around week 4-8, I started training my injured side for the first time. The first exercise I added was for the back using a “pull-over” machine. The elbow made contact with a pad where it would be pulled down to your side. This doesn’t involve any elbow flexion to occur, so it was a safe first addition.

By week 8-12, after a full range of motion was achieved, I started introducing some very light weight to my hurt arm. Simply holding a DB in an isometric DB Hammer curl to start. 20-30 lb Unilateral DB shrugs, or even just holding a DB in that hand during Bulgarian Split Squats were also on the menu but otherwise kept to a similar split as above. You definitely find ways to be creative. I started using extremely light weight on the unilateral hammer strength machines for my healing side, increase reps each week. It was amazing how weak and awkward it felt. It gave perspective on how newbie lifters must feel moving weight for the first time.

Around week 12, I was cleared to start curling weight again. I would be curling 30-50 lb DBs in my good arm, but alternated with light DBs in my healing arm. Starting at 5-10 lbs for 15-20 reps, I slowly increased weight/reps each week. You may find your forearm to become very sore and tight as it heavily compensates for lack of mind-muscle connection with the biceps. My forearm cramped up really bad in a charlie-horse at one point. So all biceps training should have the goal of activating and ‘feeling” the belly of the biceps muscle do the work.

By 5-6 months, I began back on my usual off-season strength program. I start pressing Log overhead again (starting with eccentric log Z presses to retrain the pattern, eventually graduating to push jerks from jerk boxes, finally adding in cleans) and started some sandbag carries off of an elevated box. I wasn’t quite ready for pulling implements like blocks, stones or sandbags from the floor yet, but this would help get there. Farmer’s walks started up again, and double-overhand deadlifts as well.

The very last exercises to add at 6+ months after being fully healed and strengthened are the “biceps dangerous” implements like stones, tire flips, and in my case, the event that hurt me, the axle continental clean. This is more of a mental game than physical. “Panicking” during the lift and losing form can cause injury, so this is something that must be brought back in slowly and carefully to build confidence.

6 Months later, and I’m beginning prep for the Heavyweight Arnold Amateur Strongman World Championship. Pressing strength came back relatively fast, already having hit a PR on bench press. As a 105kg Pro, I have to compete up a weight class with the big boys at the Arnold.. So the weights are heavy! But after not competing for a full year, I’m more hungry than ever to step out there and do what I do best!

My take-away points for anyone enduring a biceps tear:

• Remember there are worse injuries people have bounced back from. This is just one joint!

• Don’t let your emotions get the best of you. Approach this problem like an engineer.

• Plan for 6 months to be back to mostly normal. First 3 months for healing. The last 3 months are for strengthening.

• Always have a (smart) PLAN! 

• Train your good side and visualize training your injured side.

• Get a Spud Multi-strap (Good Mornings will help keep your deadlift up!)

• Hypertrophy over strength in the beginning. 

• Stick to your diet! Injuries can be a fast way to get lazy and fat. Don’t let this happen.

• Don’t be afraid to get a little creative

• It’s only a speedbump, one of many obstacles in the strength game. This one leaves a badass scar!

• Never give up!