Patient Education

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Ruptured Distal Biceps Tendon

A ruptured distal biceps tendon is an injury where the tendon attaching the biceps muscle to the radius bone in the forearm tears near the elbow joint. This results in significant loss of strength in elbow flexion and forearm supination (rotating the forearm palm up).

Common Symptoms

  • Sudden, severe pain in the elbow or upper forearm area
  • Visible deformity or bulge in the arm from the retracting biceps muscle
  • Weakness in bending the elbow and rotating the forearm (supination)

Cause & Anatomy

The most common cause is a sudden, eccentric load on the biceps tendon during activities that require forceful flexion and supination of the forearm, such as lifting heavy objects or during certain sports movements.

The biceps muscle has two tendons – the long head attaching to the shoulder socket and the short head attaching to the coracoid process of the scapula. The distal biceps tendon is the conjoined tendon from these two heads that inserts on the biceps tuberosity near the elbow joint.

Diagnosis

Diagnosis is made through a physical examination looking for the typical deformity “Popeye deformity”, weakness with supination/flexion, and a palpable defect in the anterior elbow crease. Imaging like X-rays, ultrasound or MRI may be done to confirm the diagnosis and rule out other injuries.

Prevention

There are no specific prevention methods, but maintaining adequate strength, flexibility and using proper technique during lifting/sports can help reduce risk. Avoiding smoking and steroids, which can weaken tendons, is also recommended.

Treatment

For younger, active individuals, surgical repair to reattach the tendon is usually recommended. Non-operative treatment with immobilization and physical therapy may be an option for less active patients.

Surgery

The torn tendon is surgically reattached to the biceps tuberosity, typically using suture anchors or a bone tunnel technique. Surgery is ideally performed within 2-3 weeks to prevent retraction and scarring of the muscle belly.

Rehabilitation After Surgery

Rehabilitation follows a criteria-based progressive protocol over 4-6 months, starting with protected motion, followed by gradual range of motion, then strengthening exercises focusing on the biceps as well as the shoulder and wrist. Return to full activities is allowed once strength is restored and functional testing is passed.

FAQ’s

How long does it take to recover from distal biceps tendon surgery?
Full recovery typically takes 4-6 months of rehabilitation to regain strength and mobility.

Can you lift weights after distal biceps tendon repair?
Yes, but heavy lifting is avoided for the first 6 months. Gradual strengthening with weights is incorporated in rehabilitation once the tendon has healed adequately.

What is the success rate of distal biceps tendon surgery?
Surgical repair has a high success rate in restoring functional strength when followed by appropriate rehabilitation.

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