T Nation

Biceps Tendon Tear Question


#1

Biceps tendon tear, let arm. Came right off the bone in the forearm. Surgery went fine for reattachment. Recovery is taking forever and is killing me!

I have googled my ass off. Muscle tears, strains, or sprains? Regular old gear will heal you right up. Stress, hairline or even minor fracture of a bone? This Boniva stuff they give women in menopause for osteoporosis can speed healing.

I can not seem to fine any substance not related to Chinese magic that is suppose to help with tendon/ligament repair.

Has anyone else?

I figure a doctor would never tell you to take 400mg of decca-durabolin to speed a hammy tear--even though it would work well so I figured my surgeon isn't going to tell me about a PED that could speed this injury up.

But now I'm not finding anything so anyone who whose heard of something I can look up and check into, I'd really appreciate it. I've got to get back to work ASAP. I guess this could have gone down in the steroid section but I'm not trying to win a strongman or bodybuilding show--I just want to accelerate healing so I thought I'd start here.

Any help would be appreciated.


#2

Growth hormone pulses seem to work really good. 3-5 IU's every 3 days.


#3

Why wouldn't your surgeon tell you? Speeding recovery after surgery would be a legit medical indication. In fact, if the risk/benefit profile was favorable, I'm sure your surgeon would Rx it him/herself.

Think about this: Biceps tendon ruptures are quite common in BBing circles, yet by your own admission you could find NOTHING online (that seemed legit) about speeding recovery. What does that tell you?

I suggest you ask your surgeon point-blank about this. I can virtually guarantee s/he will be straight with you about it. (BTW, I ruptured my distal biceps tendon [with surgical repair] in 2001. My surgeon made no mention of speeding healing via PEDs either.)


#4

I am not injured currently but I was wondering about this same thing regarding recovery


#5

I started this thread then lost where I put so I couldn't come back and read the advice, sorry about that.

Eye--I assume because of the schedule class of AS's most doctors simply don't/won't prescribe them. The body will heal itself and mine will as well in time, time that I really can't afford of course. I agree with you: why wouldn't they use it if it works, right?

But--get a nasty quad tear or disabling triceps strain you'll get 1200mg of Ibuprofuen and no one will tell you that the stuff Barry Bond's was using will drastically reduce your healing time...by weeks if not months.

I'm in your camp. I don't know why they won't help people out. There's use and there's abuse and muscle injury would seem fair use, but maybe the social stigma or misunderstanding of PEDs is just too great? We know it works (why the hell does everyone think the NFL Player Union is fighting like hell to keep HGH testing out of the league? 'Cause it speeds healing and lengthens careers in addition to helping you perform)

As for the HGH suggestion there was a thread about it on this site awhile ago. Here's my favorite quote from it:

http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_gear/has_anyone_here_used_hgh_to_heal_injured_tendonsligament

the main point seemed to be that yes HGH could help with bone/tendon/ligament healing speed (and gunshot wound trauma) but mainstream docs won't give it to you and I know I'm not going to be buying the amounts I need on the down low market.

Guess I'm out of luck. But searching HGH+tendon did get WAY more google hits.


#6

Wow. You google this you find out a Dr on the Steelers medical team 'parted ways' after it was learned he'd given over 200 pt.s HGH injections for tendonitis, arthritis, and similar ligament, bone, tendon injuries. None of the pts were Steelers--all were elderly post-surgery people except for one police officer who was shot in the shoulder and was hoping to return to duty earlier.

As of 2009 or so (as far as I could find) HGH remains the ONLY drug which can not be prescribed by a physician for "off label" use (example some anti-seizure meds are used to treat migraines, bendardryl is used to help hospital patients sleep, etc, etc).

So yeah, I could be back to work and working out but only if I go black market. Strong work congress, thank you.


#7

I'll make one final point, then let it go. You trusted your surgeon enough to allow him/her to cut you open and re-arrange your anatomy. You literally put the future of your arm (if not your life) in this person's hands. But despite this, you don't trust him/her to tell you the truth about hGH and wound healing? Furthermore, would you really put more trust in the opinions/recommendations of anonymous strangers on the internet? Color me incredulous.

As for 'knowing' it works, I'm not so sure about that. A quick PubMed search produced two (animal) studies that failed to find a positive effect (and one suggested a deleterious effect):

At any rate, here's wishing you a speedy recovery!


#8

We must have crossed paths in the conversation (this happens about 10,000 times a day on internet forums so you'd think I'd be better at realizing I'm off talking about focus A instead of focus B). Also, this isn't an argument as I think your position is reasonable and rational.

First, I don't have a problem asking the Dr. about HGH on wound healing in orthopedics. I see him in just over a week for a follow up and will bring it up. Because I'd only ever thought in terms of testosterone analogs (or EPO) in terms of accelerated healing' neither of which do anything for tendons, ligaments, or bones --and also a little bit because I don't gear up or go to a geared up gym, the idea of PEDs never entered my head until I posted, which was post-injury, post-surgery, and post initial out patient follow up.

But...I was an EMT and an LPN (once upon a time and no longer). And suddenly, while suffering through a Hallmark Channel show my wife was watching (god help me, but love is grand) and right after the Activia yogurt commercial was one for Once A Month Boniva, a med designed to increase bone density (in this instance meant for postmenopausal women at risk for osteoporosis.)

Now, way, way, back in the 90's or so when I worked at a Long Term Care facility I passed meds. And I passed Boniva and on different occasions I read charts and heard discussions of this med not only halting but (and this is the part that got me thinking) reversing osteo effects, i.e. producing knew bone, making them denser, stronger. It was/is gear for bones.

BANG! I start thinking, okay, if they can help muscle repair more quickly and they can grow thicker bones in little old ladies decades ago then maybe, just maybe, there's something out there for tendons. But I couldn't find it to open the dialog with my doc, which was the reason for my initial post. It was only after the other poster talked about GH that my mind went in that direction.

Now a couple of things. I did see the articles you referenced and read the one about the rats. I wasn't overwhelmed by the structure of that lone study and the one suggesting that it could cause harm used very careful, non-adamant language (i.e. not like the kind of words you see on the back of a bleach bottle saying DON'T DRINK!) and that it was dose related. Because of HGH having a PED stigma the most research being done is just like that of juice--in sport locker rooms.

There were/are however quite a few anecdotal testimonies from that Steelers Doctor's patients (and others) who had very good results. This immediately reminded me that all through the 1970's and into the '80's you had physicians claiming roids only worked as a placebo effect. Meanwhile Arnold and Columbo were blowing up like balloons and the dumb ass defensive tackle on your b-college football team was swearing by dinabol while Harvard MD's were scoffing it off as sugar pills.

This memory then dovetailed with observations I made while in the nursing field. A very few doctors are research orientated, outside the box, creative problem solvers (YMMV, IMO) and very few are, by nature, rule breakers. I'm not saying they aren't there--just that most I worked with (and also having much to do with which field of medicine they specialize in) they instead tend to be intelligent information memorizers type A beyond belief and conservative, cautious individuals; not prone to risking peer disapproval, and often quite satisfied with simply working within the parameters of what's been normative in the literature.

All meant as a very, very general, personal experience.

So yes--I did trust this doctor to do the specific operation he spent 14 or so years learning to do. I trusted him almost implicitly to do the surgery he'd done a thousand times before correctly and set me down my months long path of recovery like he's done with thousands of other patients.

But I don't necessarily expect him to be be pro "anti-aging" hormonal treatments, or willing to use meds or procedures that haven't had stamps of medical establishment approval that have around as long as Regan was president. Too many doctors just don't seem to be built that way. They don't do new (hell half the docs you see over 55 working don't even want to learn to enter data in a computer, lol)

I will ask him. I expect him to say "no" and a small part of me thinks he might be a young enough to admit that like the example given above, he realizes the increased healing potential and might admit it--but still won't write the script because as a PED the scrutiny a HGH prescription might bring.

Which I think was a rather long winded way of saying "I do trust him enough to ask" but I'm also a bit jaded about the medical establishment. Frankly now that I think about it, I'd probably have to pay out of pocket because my insurance wouldn't cover it to save themselves $.

However, November seems a long way away. The cabin fever is growing and I've now come across personal examples of people using hgh to speed tendon healing... so from your lips to god's ears "speedy recovery" indeed. ;-> I hope all that came across as conversational and not like one of the infamous T-Nation flame fests.


#9

You're certainly right that docs (full disclosure: I'm one myself) are by nature skeptical of therapies that have not been demonstrated to have a favorable risk/benefit ratio. ('Never be the first [OR the last] to try something new' is a guiding philosophy for most of us.) The reasons for this conservative attitude extend from the noble ('primum non nocere') to the mercenary ('I don't want to get sued').

From a pt perspective, this attitude is a double-edged sword. On one hand, it definitely delays access to therapies that are ultimately proven safe and effective. This is your lament vis a vis hGH and tendon recuperation (although as I mentioned above, I'm not sure the science is actually on your side). But OTOH, this attitude serves to protect many pts from themselves.

For example, I am appalled by the number of TNers who, despite having normal labs, have convinced themselves they need TRT, and proceed to doctor-shop until they find an unscrupulous provider who will give them what they (and their anonymous internet advisers) have decided they need. I can't help but wonder about the unnecessary morbidity/mortality this cohort will ultimately suffer because of this.

[steps off soapbox]

Thank you for the thoughtful conversation. Speaking of which, I hope the one you have next week with your bonecrusher proves satisfying. I would be very interested in hearing how it went, should you feel like sharing.


#10

I just complained about docs...to a doc. LOL. I've got to get a little better about reading those bios .

I agree with you about the studies. I understand from reading them exactly where you're coming from. Part of the cynic in me wants to point to the 1961 by Dr. Karl Klein damning squats as knee wreckers almost as bad a car wreck. Studies, have problems. Now squats, and deep squats, are seen as knee builders on par with the blessing hand of Jesus. Between that and the hula baloo about eggs (good! bad! good!) I'm always a little nonplussed at singular studies.

But the truth is you are correct--the study on the rats didn't look good and the only thing going against it is the anecdotal evidence of the Steelers MD's pts. And I agree with you that anecdotal evidence isn't science. So no gray market purchase for me and no doc shopping--I'm 100% with you.

I will just bring it up in the appointment then post next week to let you know what he says.

And again, the irony of my MD observations to an MD is the height of face palm irony. You took it very well 8-}

EDIT: do you have a general, no legally binding, non-licensed opinion on
Alflutop? Other than equipose (which I'm not taking and certainly not getting from my MD) it is the touted 'cartilage repair'. I'm asking at my appt but I just thought I'd throw it out there since we're in a discussion.


#11

Re Alflutop--sorry, never heard of it prior to you mentioning it here.


#12

Your Dr will never prescribe them.. but standard post op healing protocol for tendon surgeries by many looks like this. HGH 5iu 5 on 2 off for minimum of 3-6 months. IGF-1LR3 50 mcg per day 5 on 2 off for months 1-3-5 post op..


#13

I personally tore my distal bicep off and had it surgically repaired.. I was back to stronger than before the surgery in 6 months. FYI. The surgeons said a year before I would be lifting without restrictions.


#14

If you find the right studies you will see that although the medical community wont research it in the US.. Due to the bad juju with HGH that is tied to our wonderful laws that lumped it in with steroids a few years back. Little known fact it is one of the few medications that physicians are restricted from prescribing off label.. and healing is considered off label. Im not going to sit here and site sources or studies but If you spend enough time and look in the right places you will come to a similar conclusion. And Im not talking about N=1 studies either.. There is solid evidence out there and I have utilized it multiple times to heal and it cut my time in half.


#15

I may be an idiot but what do you mean when you say off label?


#16

Meds are approved for use with specific indications by the FDA based on studies completed by the companies who market them. Physicians can legally use them for other purposes if they deem appropriate, this would be considered prescribing a med off label. The label being the FDA APPROVED uses. Very few of them one being HGH cannot be legally written off label. Hence the reason you have almost no data in the US for tendon healing.

Other than underground info. It is widely used for the rehab purposes in the pro sports world.. The head in the sand physicians who know little behind the scope of their practice would never recommend or even be aware of this. So asking an MD in the US Will 99.99% of the time lead to them both saying no and spinning some drivel like the above about how to trust what they say even though they have little or no scientific data to back up thier assumptions.. They are just following FDA rules.


#17

e.g. they use seizure meds off label for migraines and another big one is allergy med benadryl for a sleep aid. He's right, they do it all the time.

Swolle, in my experience is also correct in that unless you get into an anti-aging clinic that could or could not end up busted depending on how they operate, along with the client list--the chances of getting HGH for healing is nearly impossible because you can use it to get bigger in sports. Which is insane. People need, in the context of their lives, heal as rapidly as possible and they're getting short changed because Barry Bonds or Jose Censaco or Lance Armstrong come to MD's/FDA's minds (it not being the point if they were or weren't on it; it's all just PEDs to them and thus 'bad')

My doctor's nurse, when I found out that Alflutop was a legal, non-PED associated med and her response was almost scathing "it comes from Romania" like I was trying to win a gold medal in weightlifting instead of speed going back to work. It's not FDA approved here so he couldn't prescribe it anyway--but it wasn't much of an academic conversation as a dismissal. Lesson learned.

(edit: to any doc reading this, I'm speaking off the cuff)


#18

Tons of meds are or were used off label.. Many times companies do studies because physicians have found other uses for their products. And you hit the nail on the head when it comes to PEDs and the mainstream physicians. Its not their fault it is simply that the media and government has placed a huge stigma on their use regardless of the purpose.

So here we are.. Technically just so you know HGH in athletes is not so much used to get big as it is to heal up so they can continue to play week after week after week and still be at the top of their game. People expect so much from these stars.. They are only human and need to play at superhuman levels week in and week out and more often than not now days they are using things like hgh to make that possible. HGH didn't make them better it just makes them heal up for the next game.

And for any Doc reading this... I am not speaking off the cuff.. Eye dentist is clearly not a medical physician.. Like Stu in the Hangover you're a dentist or you would have known that HGH cannot be prescribed off label.

Excerpt and crap by the way.. if you follow why congress outlawed it you will find Pro Baseball players and media outrage that is all.

"Off-label use for many drugs is a normal and accepted practice in medicine, but that is not true for growth hormone," says coauthor S. Jay Olshansky, PhD, from the University of Illinois at Chicago School of Public Health. "According to laws instituted by Congress more than 10 years ago, HGH can only be distributed for indications specifically authorized by the Secretary of Health and Human Services, and aging and its related disorders are not among them. The use of HGH as an alleged antiaging intervention is a major public health concern not just because it is illegal, but also because its provision for antiaging is not supported by science and it is potentially harmful."


#19

I am an MD; the username 'EyeDentist' refers to the fact that I'm an ophthalmologist. (I'm also a PhD, but in a non-medical field). The prohibition against off-label prescribing of hGH is in response to, and is intended to curb, the (ab)use of hGH in so-called 'anti-aging' clinics.

In light of this post, I asked my orthopod colleagues 1) whether they felt hGH was efficacious in promoting post-op tendon healing, and 2) if it was, whether prescribing it for this indication would get them in hot water with the Feds. While none were aware of evidence supporting hGH use for this indication, neither did they think its use in this manner would violate the FDA ban on off-label use of hGH. (This was a nonscientific survey, obviously.)


#20

I would also like to add that the three of us--pulphero, Swolle, and I--are actually on the same side of this issue, in that all of us have suffered a biceps-tendon rupture, and therefore are all at risk for rupturing the other one as well. My point is, I am as interested as you guys in the availability of adjunctive therapies for promoting post-op healing, because there is a nonzero chance I am going to be a candidate for it myself someday. Where we differ seems to be in terms of 1) the level of evidence we're willing to accept vis a vis demonstrating the safety/efficacy of hGH as a post-op adjunct, and 2) our faith in individual physicians to 'do the right thing' in providing care to their pts.

But I can say in all honesty that I hope you guys are right about hGH; ie, I hope it turns out to be safe and efficacious in promoting tendon repair.