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Biceps Tendon Rupture

What is the Biceps Tendon?

The biceps muscle is present on the front side of your upper arm and functions to help you bend and rotate your arm. The biceps tendon is a tough band of connective fibrous tissue that attaches your biceps muscle to the bones in your shoulder on one side and the elbow on the other side. Two tendons attach the biceps muscle to the bones in the shoulder, the long-head tendon that attaches the muscle to the top of the shoulder's socket (glenoid) and the short-head that attaches it to the shoulder blade. Tears are more likely to occur in the long-head of the biceps tendon. Tears of the short-head of the biceps are very rare. In case of a complete tear of the long-head, the short-head of the biceps may allow you to continue using your biceps muscle.

Causes of Biceps Tendon Rupture

Most biceps tendon ruptures occur at the shoulder from an injury, such as a fall on an outstretched arm or from overuse of the muscle with repetitive overhead activities and sports such as with tennis and swimming.

Biceps tendon ruptures are common in people over 60 who have developed chronic micro tears from degenerative changes and overuse. These micro tears weaken the tendon making it more susceptible to rupturing.

Other causes can include frequent lifting of heavy objects while at work, weightlifting, long term use of corticosteroid medications and smoking.

Types of Biceps Tendon Rupture

Biceps tendon rupture can either be partial, where it does not completely tear the tendon, or complete, where the biceps tendon completely splits in two and is torn away from the bone.

Symptoms of Biceps Tendon Tear

Symptoms that may occur with biceps tendon rupture include:

  • A popping sound
  • A snapping sensation
  • Pain with overhead activity
  • Weakness in the shoulder
  • Bruising in the upper arm

Diagnosis of Biceps Tendon Tear

Your doctor diagnoses a biceps tendon rupture after observing your symptoms and taking a medical history. A physical exam is performed where your arm is moved in different directions in order to see which movements elicit pain or weakness. Imaging studies such as X-rays may be ordered to assess for bony deformities such as spurs, which may have caused the tear. An MRI scan can help determine if the tear is partial or complete.

Treatment Options

Nonsurgical treatment includes:

Rest: A sling is used to rest the shoulder and you are advised to avoid overhead activities and heavy lifting until healed.

Ice: Applying ice packs for 20 minutes at a time, 3 to 4 times a day, helps reduce swelling.

Medications: Non-steroidal anti-inflammatory medicines help reduce pain and swelling.

Physical therapy: Strengthening and flexibility exercises help restore strength and mobility to the shoulder joint.

Surgery for Biceps Tendon Repair

Surgery may be necessary if your symptoms are not relieved by conservative measures and if you are an athlete and require full restoration of strength. Your surgeon makes an incision near your shoulder where the tendon is torn. The torn end of the tendon is cleaned, and the bone is prepared by creating drill holes. Sutures are woven through the holes, and the tendon to secure it back to the bone and hold it in place. The incision is then closed and a dressing applied.

Risks and Complications of Bicep Tendon Repair

As with any surgery, complications can occur related to the anesthesia or the procedure. Most patients suffer no complications following biceps tendon repair; however, complications can occur and may include:

  • Infection
  • Nerve damage
  • Re-rupture of the tendon