A biceps tendon tear is an injury where the tendon that attaches the biceps muscle to the bone gets torn or ruptured. There are two main types – proximal (at the shoulder) and distal (at the elbow).

Common Symptoms

• Sudden, severe pain in the upper arm or elbow
• Visible deformity or bulge in the upper arm (for proximal tears)
• Swelling and bruising around the elbow (for distal tears)
• Weakness in bending the elbow or rotating the forearm

Cause & Anatomy

• Injury from a sudden, forceful pull on the biceps tendon, like during heavy lifting
• Overuse and degeneration of the tendon over time
• Risk factors include age, smoking, and use of corticosteroids

The biceps muscle has two tendons attaching it to the shoulder (long head and short head) and one tendon attaching to the elbow (distal biceps tendon). The distal biceps tendon attaches to the radius bone near the elbow joint.

Diagnosis

• Physical exam to check for pain, swelling, bruising, weakness, and deformity
• Imaging tests like X-rays, MRI or ultrasound may be done to confirm the tear and evaluate the extent
• It is critical to determine if it rupt

Prevention

There are no proven methods to definitively prevent biceps tendon tears, but maintaining overall muscle strength and avoiding overuse injuries can help reduce risk.

Treatment

Nonsurgical:

• For partial tears or low functional demand, treatments like rest, ice, anti-inflammatory medication, and physical therapy may be tried

Surgical:

• Complete tears, especially distal biceps tears in active individuals, are usually repaired surgically to reattach the tendon to the bone. Tears at the shoulder may be repaired depending on the patient function and other problems at the shoulder.

Surgery

The goal is to reattach the torn tendon, often using minimally invasive techniques.

Rehabilitation After Surgery

A phased, criterion-based rehabilitation program is followed, progressing from immobilization to range of motion, then strengthening exercises over 3-4 months. Careful progression avoids overstressing the repaired tendon.

FAQ’s

Can a biceps tendon tear heal without surgery?
Partial tears may heal with nonsurgical treatment, but complete tears, especially distal biceps tears, often require surgery for optimal arm strength and function.

How long does it take to recover from biceps tendon surgery?
Recovery typically takes 3-6 months with rehabilitation to regain full strength and function after biceps tendon repair surgery.

What is the success rate of biceps tendon surgery?
Surgical repair of biceps tendon tears has a high success rate, with low rates of re-tearing the tendon when properly rehabilitated.

There is a big difference in biceps tears at the shoulder versus the elbow. Your surgeon can help diagnose and determine the correct treatment.