Diagnosis

Tears are usually obvious due to the pain and swelling of the muscle. Our consultants will ask about the events around the injury, and will examine the injured site including comparing the injured muscle against the opposing non injured muscle. If the injury involves a cut, this will usually be examined under local anaesthetic in an operating theatre. Further tests required may include ultrasound, or an MRI. If there is a concern about joint injuries as well as the muscle a CT scan may be requested.

Treatment options

• Watch and wait: For most tears, no active treatment is required. They should be rested and protected for 6-12 weeks. If the tear is complete, surgery is recommended to avoid significant weakness and potential disability.
• Surgery: If surgery is required the muscle or tendon will generally be repaired under local anaesthetic for below the wrist, and above the wrist under general anaesthetic or regional anaesthetic (making your arm numb). Muscle repairs do not hold sutures well, and so need careful protection and care for 4 -6 weeks after surgery. Tendons hold sutures well, but they heal slower. They also tend to scar to surrounding tissues and so early supervised movement with a hand therapist is important to avoid this

After surgery our Hand Therapists will guide you through important stretches, bending and straightening of the joint, most movement is gained in the first 6 – 12 weeks. Return to heavier work may take 9 – 12 weeks, but your consultant and hand therapist will be able to guide you about this. Full movement of the joint is rare after a complete tear, but typically you will gain movement to achieve 90% of tasks that you could complete pre-injury. This may be less if multiple muscles were involved. 10% of patients may require further surgery; this is more common among the complex and multiple tear injuries.

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