I work as a self-employed construction contractor. He ruptured his biceps tendon at the elbow while lifting something heavy. How long before he can return to work? With him being gone, we are all off work. I can’t afford to be without employment for more than a week before I’ll have to find something else.

When there is a complete rupture of the biceps where it attaches to the elbow, the question for a self-employed, self-insured, under insured, or uninsured individual becomes: will it heal on its own? The patient often wants to know, “Will I get back to ‘normal'”?

Most orthopedic experts agree that surgery is needed. And the best time to repair a biceps tendon that has retracted (snapped back up into the upper arm) is within the first six weeks after injury. In fact, the best results with fewest complications occur when surgery is done in the first two weeks after injury. After six weeks, reconstruction with a graft (rather than a repair procedure) is more likely.

Without surgical repair, the patient can expect about a 40 per cent loss of supination (palm up) motion. There can be another 30 per cent loss of strength. And there could still be other complications such as nerve injury, bone fracture, and even re-rupture of the biceps. It’s not likely the arm will get back to normal without intervention.

Without treatment someone with a biceps rupture can experience continued weakness whenever trying to turn or twist (supinate) the forearm. This type of motion is usually important for construction work. Easy fatigue of the injured arm may be likely as well. Some people can adapt to these changes while others cannot.

Whatever decision your employer makes (return to work immediately, take time off and heal, or have surgery) will likely be made in the next week. You will know then what your options are in order to make employment decisions for yourself.