Anatomy of the Biceps Tendon
The biceps muscle, located in the front of the upper arm allows you to bend the elbow and rotate the forearm. The distal biceps tendon attaches the biceps muscle in the arm to the radius bone in the forearm.
What is a Bicep Tendon Tear?
A biceps tear can be complete or partial. Partial biceps tendon tears will not completely break the tendon while complete tendon tears will break the tendon into two parts. Tears of the distal biceps tendon are usually complete and the muscle is separated from the bone. Tears of the distal biceps tendon most often result from a sudden injury, commonly when lifting a heavy object.
Causes of Bicep Tendon Tears
A biceps tendon tear can be caused by an injury where your elbow is forced against resistance. Other problems such as tendonitis are more likely to weaken or tear the biceps tendon. Additional risk factors such as advancing age, smoking and use of corticosteroids can also result in a tendon tear.
Symptoms of Bicep Tendon Tears
The most common symptom of a biceps tendon tear is sudden, severe pain at the elbow. At times, you may hear a pop. Other symptoms may include swelling, visible bruising, weakness in the elbow, and trouble twisting the forearm. A bulge in the upper region of your arm may appear, and there may be a gap in the front of the elbow due to the absence of the tendon.
Diagnosis of Bicep Tendon Tears
A biceps tendon tear is usually diagnosed based on your symptoms, medical history, and a physical examination. During the physical examination, your doctor will look for a gap in the front of the elbow. Your doctor will diagnose a partial tear by asking you to bend your arm and tighten the biceps muscle. You may have pain if there is a partial tear. X-rays may be taken to rule out other conditions causing elbow pain. Using an MRI scan, your doctor can confirm if the tear is partial or complete.
Treatment Options for Bicep Tendon Tears
Non-surgical Treatment Options for Bicep Tendon Tears
Conservative treatment for a proximal biceps tendon tear includes:
- Ice application
- Limiting activity
- Non-steroidal anti-inflammatory medications to reduce the pain and swelling
- Flexibility and strengthening exercises to restore mobility and strength of the surrounding muscles
Surgery for Distal Bicep Tendon Tears
Surgery to reattach the torn tendon back to the bone may be needed, particularly if the tear is complete. This may also be the best option for patients with partial tears who continue to experience symptoms after non-surgical treatments or who want all their arm strength back, such as athletes or manual laborers.
Your surgeon may opt for several surgical procedures for distal bicep tendon tear where the distal biceps tendon is reattached to the forearm bone. One or two incisions may be used. During the procedure, the tendon is re-attached with sutures and anchored to the bone using a small metal button or a biocomposite screw.
Post-surgical Care for Bicep Tendon Tears
Following surgical repair, you will be instructed to avoid any lifting acrivities while the repair heals. You will also be advised on flexibility and motion exercises to help prevent stiffness.
Risks and Complications of Bicep Tendon Tears
Complications are rare but may include numbness and weakness in the forearm, new bone formation, limited movement and possible re-tearing.
- Triceps Injuries
- Osteochondritis Dissecans of the Capitellum
- Elbow Trauma
- Elbow Arthritis
- Bicep Tendon Tear at the Elbow
- Elbow Dislocation
- Triceps Tendonitis
- Elbow (Olecranon) Bursitis
- Elbow Sprain
- Tennis Elbow
- Golfer's Elbow
- Little League Elbow
- Nursemaid's Elbow
- Elbow Pain
- Elbow Contracture
- Distal Humerus Fractures of the Elbow
- Radial Head Fractures of the Elbow
- Elbow Fractures
- Ulnar Nerve Neuropathy
- Loose Bodies in the Elbow
- Radial Tunnel Syndrome
- Lateral Ulnar Collateral Ligament Injuries (Elbow)
- Post-traumatic Stiffness (Elbow)
- Cubital Tunnel Syndrome (Ulnar Nerve Entrapment)