The biceps muscle functions to help you bend and rotate your arm. lt is in the front side of your upper arm. The biceps tendon is a tough band of connective fibrous tissue that attaches the biceps muscle to the bones in the shoulder on one side and the elbow on the other side. A biceps tendon rupture can either be partial, when it does not completely tear or complete, when it splits in two and is torn away from the bone.
The biceps tendon can tear at the shoulder joint (distal biceps tendon rupture) or elbow joint. Most biceps tendon ruptures occur at the shoulder, which is referred to as a proximal biceps’ tendon rupture. When it occurs at the elbow it is referred to as a rupture and is less common. Overuse and injury can cause fraying of the biceps tendon and eventual rupture.
Biceps tendon ruptures occur most commonly from an injury, such as a fall on an outstretched arm, or from overuse of the muscle, either due to age or from repetitive overhead movements such as with tennis and swimming.
Biceps tendon ruptures are common in people over 60 who have developed chronic micro- tears from degenerative change and overuse. These micro-tears weaken the tendon, making it more susceptible to rupture.
Other causes can include frequent lifting of heavy objects at work, weightlifting, long-term use of corticosteroid medications.
The most common symptoms of a biceps tendon rupture include:
- Sudden, sharp pain in the upper arm
- An audible popping sound at the time of injury
- Pain, tenderness, and weakness at the shoulder or elbow
- Trouble turning the arm palm-up or palm-down
- A bulge above the elbow (the “Popeye” sign)
- Bruising to the upper arm
Yottr doctor diagnoses a biceps tendon rupture after observing your symptoms and taking a medical history. A physical exam is performed where your arm may be moved in different ways to see which movements elicit pain or weakness. Imaging studies such as X-rays may be ordered to assess for bone deformities such as bone spurs, which may be the cause, or an MRI scan to determine whether the tear is partial or complete.
Non-surgical treatment is an option for patients whose injury is limited to the top of the biceps tendon. This includes:
- Rest: A sling is used to rest the shoulder, and you are advised to avoid overhead activities and lifting heavy objects until the bicep tendon has healed.
- Ice: Applying ice packs for 20 minutes at a time, 3 to 4 times a day, to help reduce swelling.
- Medications: Non-steroidal anti-inflammatory medicines help reduce pain and swelling.
- Physical therapy: Strengthening and flexibility exercises help restore strength and mobility to the shoulder joint.
Surgery may be necessary for patients whose symptoms are not relieved by conservative measures and for patients some athletes who require full restoration of strength.
Depending on which end of the tendon iS torn the surgeon will make an incision either near the elbow or shoulder. The torn end of the tendon is cleaned, and the bone is prepared by creating drill holes. Sutures are woven through the holes and the tendon to secure it back to the bone and hold it in place. The incision is then closed, and a dressing applied.