That pesky biceps issue

Posted by ESPN.com's Kevin Seifert
Just three months ago, Brett Favre said his primary reason for retiring was a partially torn biceps tendon that would require surgery. On Tuesday, ESPN's Chris Mortensen reported that Favre has decided against surgery and is hopeful the injury will heal on its own and enable him to play for Minnesota this season.

So what has changed? Is it possible for Favre to play without surgery?

The answer is yes. I spoke with ESPN's Stephania Bell about that issue Monday -- in preparation for the inevitable day when we got word that Favre was considering a comeback. Bell, who is a certified orthopedic clinical specialist, agreed that one of Favre's three options is to decline surgery.

Bell was careful to point out that she has neither examined Favre nor spoken directly to anyone associated with his medical care. But if media reports are accurate about the extent of his injury -- that the biceps is partially torn away from the shoulder -- it is possible for the injury's primary impairments to dissipate on their own.

The most efficient way for that to happen, Bell said, is if the tendon fully tears on its own. This event would allow the arm to heal naturally and would eliminate the inflammation and discomfort that plagued him at the end of last season. Favre had a similar injury to his left biceps earlier in his career and followed the same non-surgical path.

"The injury itself is not that big of a deal," Bell said. "Really, what bothered him last year was the side effects: The discomfort caused by having that partial tear. Once it tears all the way, it's actually relieving and it has no affect on how a quarterback can throw a ball."

There are also two surgical procedures available, one that would require a short rehabilitation and one that would take four to six months.

A tenotomy, where surgeons complete the tear themselves, has a "very quick recovery," Bell said. "Basically, they would just release the tendon themselves." If Favre decided to undergo this procedure, he would be ready to practice long before training camp begins in July.

A tenodesis, on the other hand, is where surgeons re-attach or re-anchor the tendon. According to Bell, it could take up to six months for an NFL quarterback to rehabilitate his arm after that procedure. So rule that one out.

Again, Favre appears to be choosing no surgery at all. Mortensen reports that his agent, Bus Cook, is looking to match Favre with a quarterback coach to help guide him through the throwing portion of his rehabilitation.

"It would be a situation where he would need to keep the swelling and inflammation down," Bell said. "That's the problem with this injury, not the tear itself. It's all the havoc that a tear creates around the injury. If the swelling goes down, and I'm sure it has this offseason, it would be a matter of keeping it that way."