Rupture of the Biceps Tendon

The biceps muscle is in the front of your upper arm. It helps in bending your elbow, rotational movements of your forearm and maintaining stability in the shoulder joint. It has two tendons, one of which attaches it to the shoulder bone (proximal biceps tendon) and the other attaches it at the elbow (distal biceps tendon). The biceps tendon can tear at the shoulder or elbow with overuse, or injury when you lift heavy objects or fall on your hand.

Biceps tendons can tear partially or completely. The most common symptoms are sudden, severe pain in the upper arm, “pop” sound, swelling, visible bruising, weakness in the elbow, trouble turning your arm from a palm up to a palm down position, and a gap in the front of the elbow caused by the absence of the tendon. A characteristic bulge called a “Popeye muscle” may appear in your arm caused by the recoiled, shortened biceps muscle.

Biceps tendon rupture is usually diagnosed based on your symptoms, medical history and physical examination. During the physical examination, your doctor will look for a gap in the tendon by palpating the front part of your elbow, and diagnose a partial tear by the presence of pain when you bend your arm and tighten the biceps muscle. X-rays may be taken to rule out other conditions causing elbow pain and an MRI scan, to determine if the tear is partial or complete.

Mild biceps tendon tears can be treated with conservative methods such as rest, ice application, non-steroidal anti-inflammatory medications (NSAIDs) and physical therapy. When nonsurgical methods fail to relieve symptoms, surgery is performed to reattach the torn tendon to the bone. This can be done by drilling holes in the bone and anchoring the tendon with stitches or by using small metal implants.