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I work in a feed plant as my regular job but I also play violin in our local symphony orchestra. Last week, I ruptured my left biceps tendon lifting a bag of feed that was too heavy. Now I'm paying for that little piece of stupidity. The surgeon put me back together. How long before I can pick up a violin and play again?

You should check with your surgeon to find out what, if any, restrictions he or she would like you to follow. Sometimes the follow-up home or rehab program depends on the type of surgery, type of sutures used, placement of sutures, and so on. Some procedures allow for a more aggressive rehab program. Immobilization is only required for a day or two, whereas in other cases, the elbow remains in a sling much longer. Most rehab protocols require a week or more of immobilization before allowing a gradual increase in active motion. The thinking behind the conservative approach is that the body needs time to allow tendon ingrowth into the bone. Too much stress too soon could disrupt the surgical site. But surgeons have noticed that patients who don't follow their instructions and who return to aggressive activities earlier than they should, seem to do just fine. In fact, no matter how the injury is treated in the postoperative rehab program, everyone seems to have the same results. And tendon rerupture is rare. That's good news for patients like you who have a need to get back into action sooner than later. Having said that, please be aware that there is a difference between encouraging elbow motion and allowing activities that require strength, such as lifting heavy objects. Even with an aggressive rehab program, lifting is restricted to one-pound for the first six weeks. Then the patient is allowed to increase to two pounds until a gradual increase to full weight at the end of three months. With a job that requires heavy lifting, following the restrictions placed on you will be extremely important. Playing the violin may have its own challenges. Some patients report difficulty fully supinating (rotating) the forearm (palm up). Motion and strength of the forearm are both affected and this can interfere with holding the violin. If you work with a physical therapist, he or she can help you regain the motions, strength, and function needed for both your job and your music.

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