Get the Facts: Biceps Tendon Rupture

Christopher C. Dodson, MD August 24th, 2015
It can happen when helping out a buddy on moving day or when you are unjamming a relative’s stuck window on a sweltering day. Unexpectedly, you may have suffered a bicep rupture if you felt an acute pain during a lifting motion. In some cases, active individuals could experience a rupture through contact sports or weightlifting. In reality, the injury is abrupt in nature. The physicians at Rothman Orthopaedic Institute understand that you need immediate counsel when facing biceps tendon rupture.
Defining Biceps Tendon Rupture
The biceps are tendons made of strands of collagen that are bundled together. The biceps are located in the upper arm attaching to the shoulder and the elbow bones. Acting as a source of stability and functional rotational movement, the bicep is made to endure forces that pull on both ends. When injured, the biceps capacity for high tensile strength is compromised.
Biceps tendon rupture will occur most commonly at the shoulder near the rotator cuff. This part of the tendon is known as the long head. A tear at the elbow will affect the distal biceps tendon.
How the Biceps Tendon Ruptures: Injury & Overuse
A biceps tendon rupture happens when the elbow is straightened in a forced way against some kind of resistance whether a box or one’s own body weight during a fall. The stress causes the tendon to tear. A partial or complete tear may occur.
At the shoulder, repetitive overuse can cause the tendon to fray at a slow pace over long periods of time. Other shoulder problems may be an indication of an increased rupture risk including shoulder tendonitis, shoulder impingement, or any rotator cuff injuries.
Rothman Orthopaedic Institute physicians will diagnose your biceps injury during your initial appointment utilizing both X-Ray and MRI images. Complete ruptures can cause other arm and shoulder muscles to attempt compensate on behalf of the injured biceps. In some cases, the substituted functionality of other muscles can cause damage, such as in the rotator cuff tendons.
Doctors at Rothman Orthopaedic Institute have the experience and expertise to determine the best treatment plan to fit your needs. Medical history, age, activity level, lifestyle will be considered, but the primary starting point will be an evaluation of current symptoms. Because the biceps tendon rupture can occur at either the elbow or the shoulder, two different sets of symptoms will be assessed, including:
Tear at the Elbow
  • Bruising located at the elbow or forearm

  • Frontal swelling around the elbow

  • Elbow weakness when performing a bending motion

  • Difficulty twisting the forearm

  • A visible upper arm bulge

  • The appearance of a “gap” around the front of the elbow

Tear at the Shoulder
  • Sudden and acute upper arm pain

  • A noise sounding like a “pop” or “snap”

  • Bicep cramping during intense use

  • Bruising around the midpoint of the upper arm

  • Tenderness and weakness at both the shoulder and elbow

  • Difficulty rotating the palms of your hands

  • A bulge in the upper arm and the appearance of a “dent” near the shoulder

A biceps tendon rupture at the ELBOW almost ALWAYS requires surgery whereas an injury at the SHOULDER typically can be treated nonoperatively. Nonsurgical treatments include a combination of icing, nonsteroidal anti-inflammatory medication, rest and physical therapy to relieve pain and help restore functionality.
Surgery is recommended for shoulder tears when nonsurgical treatments are ineffective. The procedure involves reattachment of the tendon through a minimally invasive incision. At the elbow, the distal biceps tendon is once again anchored to the forearm bone with either stitches or metal implants. Physical therapy following surgery is an important component of rehabilitation, and will be required.
For more information or to schedule a biceps tendon rupture evaluation, contact Rothman Orthopaedic Institute at 1-800-321-9999.

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