What is a biceps tendon tear?
The biceps muscle is located in the front of your upper arm. It allows you to bend your elbow, rotate your forearm, and maintain shoulder stability. If you tear the biceps tendon at the elbow, you will lose strength in your arm and be unable to forcefully turn your arm from palm down to palm up.
Once torn, the biceps tendon at the elbow will not grow back to the bone and heal. While other arm muscles make it possible to bend the elbow fairly well without the biceps, they cannot fulfill all the functions, especially the motion of rotating the forearm from palm down to palm up. Without surgery, the injured arm will suffer a 30-40 percent decrease in strength, mainly in twisting the forearm.
Biceps tendon tears can be either partial or complete. Men age 30 or older are most likely to tear the biceps tendon.
What causes a tear?
The main cause of a biceps tendon tear is a sudden injury, such as trying to catch a heavy falling object or trying to lift a heavy box.
What are symptoms of a biceps tendon tear?
There is often a “pop” at the elbow when the tendon ruptures. Pain is severe at first, but may subside after a week or two. Other symptoms include:
- Swelling and pain in the front of the elbow
- Visible bruising in the elbow and forearm
- Weakness in bending of the elbow
- Weakness in twisting the forearm (supination)
- A bulge in the upper part of the arm created by the recoiled, shortened biceps muscle
- A gap in the front of the elbow created by the absence of the tendon
How is it diagnosed?
Your doctor will review how your injury occurred. A physical examination will determine whether there’s a gap in the tendon. Your physician will also test your ability to rotate your forearm against resistance and compare it to the strength of your other arm. Imaging tests, such as x-rays and magnetic resonance imaging (MRI), may also be performed to confirm a diagnosis.
How is a biceps tendon tear treated?
Treatment consists of both surgical and non-surgical approaches. Non-surgical treatment may be considered for those who are elderly and inactive, or who have medical problems that make them high-risk for modest surgery.
Surgery is the preferred treatment for most patients. It should take place within two to three weeks after the injury before tendons and muscles begin to shorten, but can be done up to six weeks after the injury. There are several types of procedures to reattach the biceps tendon to the forearm. You and your physician will discuss the available options.