The biceps muscle is located 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 to the shoulder bone (proximal biceps tendon) and the other attaches 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 bending the elbow, weakness in twisting the forearm into supination (palm up)., and a gap in the front of the elbow caused by the absence of the tendon. Tearing the upper biceps tendon can cause a characteristic bulge in the muscle above the elbow called a “Popeye muscle.” that may appear in your arm caused by the recoiled, shortened biceps muscle. This is also referred to as a “dropped” 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 and an MRI scan may be done to rule out other conditions causing elbow pain, and 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 referred to as suture anchors.
Complete tears of the biceps tendon at the shoulder and elbow are best treated early, preferably within 3 weeks after injury. If you think you have torn your biceps tendon, have your doctor evaluate this as soon as possible.
© James B. Grimes, MD Orthopaedic Surgeon Minimally Invasive Hip Knee Shoulder Surgery Bakersfield California
