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Biceps Tendon Tear

Expert Orthopedic Shoulder Surgeons in Orange County

The Anatomy of the Biceps Muscle

The biceps muscle is located in front of your upper arm. It helps in bending your elbow as well as in rotational movement of your forearm. It also helps to maintain the stability in the shoulder joint. The biceps muscle has two tendons, one of which attaches to the bone in the shoulder and the other attaches at the elbow.

What are biceps tendon tears?

Rupture of the biceps tendon can occur proximally (at the shoulder) or distally (at the elbow). A biceps tendon tear is typically caused either by an injury or overuse. When there is an unexpected force applied to the bicep muscle, or twisting your elbow or shoulder in an awkward way, such as falling down with your arm outstretched or lifting something too heavy – can all lead to a biceps tendon tear. A tear can also be complete or partial.

Torn tendons also can begin fraying over time and lead to either a partial or complete tendon tear as the damage progresses. Patients who tear their biceps tendon often have damage to other parts of the shoulder, such as the rotator cuff tendons. Without treatment, biceps tendon tears can lead to many other shoulder problems from tendonitis to shoulder impingement, and rotator cuff injuries.

Biceps Tear Symptoms

A sudden, severe pain in the upper arm or at the elbow is the most obvious symptom of a biceps tendon tear. Other signs of a biceps tendon tear include the following:

  • Sharp pain in the shoulder or elbow.
  • Cramping of the biceps muscle with strenuous use of the arm.
  • Appearance of a bruise on the upper arm or forearm near the elbow.
  • Weakness in the shoulder or elbow.
  • Difficulty rotating your forearm with the elbow bent “palm up” or “palm down.”
  • An audible pop or snap in the shoulder.

A bulge of the front of your bicep in the upper arm

Biceps Tendon Tear Diagnosis

Your doctor may be able to discern a biceps tendon tear from a physical examination for a complete rupture, due to seeing the “Popeye Muscle” arm deformity, but partial ruptures are less obvious. These partial tears can be diagnosed by bending the arm and tightening the biceps muscle. If you experience pain using your biceps muscle, it may mean you have a partial biceps tendon tear. Your doctor may also diagnose rotator cuff injuries, impingement, and tendonitis along with a biceps tendon tear. Additional tests, including X-rays and MRI scans, can rule out other related problems causing shoulder or elbow pain and to see the soft tissues of the arm.

Biceps Tendon Repair Treatment

Many people can still function with a distal biceps tendon tear (elbow) reasonably well, but will experience a decrease in palm-up rotation of their arm. Because of this many will choose surgical treatment. For proximal biceps tears (shoulder), surgery is often pursued when symptoms continue and if there are remaining cosmetic “Popeye” bulging muscles visible.

Nonsurgical Treatment of Biceps Tendon Tears

Non-surgical treatment may be a reasonable option if you have not damaged a critical shoulder structure and you only have a small, partial tear. Conservative, non-surgical treatments include:

  • Rest: Avoid activities that aggravate the biceps tendon such as heavy lifting and overhead activities
  • Ice: Apply ice 20 minutes at a time, several times a day to help control swelling
  • Anti-inflammatory medication: Taking non-steroidal anti-inflammatory medications to reduce pain and swelling
  • Physical therapy: Your doctor may prescribe physical therapy and rehabilitation for additional flexibility and strengthening to restore movement in the shoulder.

Surgical Treatment of Biceps Tendon Tears

Surgery is not always necessary for partial tears, but may be recommended for more active adults. For complete biceps tears, surgery may be necessary as the first-line treatment, depending on the location of the tear.

  • Distal (elbow) biceps tendon ruptures typically require surgical fixation to restore range of motion and strength to the elbow. This procedure is known as "distal biceps tenodesis" and is an open surgical procedure that can be performed on an outpatient basis. The goal of this procedure is to reattach the tendon to the radius bone using either sutures or an anchor with sutures.
  • Proximal (shoulder) biceps tendon ruptures can be treated by a procedure known as “proximal biceps tenodesis,” where the biceps tendon is attached to the upper arm bone (humerus). This procedure can be performed a number of ways, including soft tissue and hard tissue techniques. Your shoulder surgeon will determine the right biceps tenodesis procedure to help you heal.

Trust the Shoulder Surgeons at Newport Orthopedic Institute

Our board-certified, fellowship-trained Orange County shoulder surgeons are experts at treating biceps tendon tears with arthroscopic biceps tendon repair surgery.

Do you have a biceps tendon tear?
Call Newport Orthopedic Institute at (949) 722-7038.

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