Biceps Tendon Tears [Elbow]

What is a biceps tendon tear?

The biceps muscle is located in the front of your upper arm. It allows the elbow to bend, the forearm to rotate, and maintains shoulder stability. If you tear the biceps tendon at the elbow, you will lose strength in your arm as a result, and will be unable to forcefully turn your arm from palm down to palm up.

Once torn, the biceps tendon at the elbow will not grow back to the bone and heal. While other arm muscles make it possible to bend the elbow well enough without the biceps, they cannot fulfill all functions, particularly the motion of rotating the forearm. Without surgery, the injured arm will suffer a 30-40 percent decrease in strength, mainly in twisting the forearm.

Biceps tendon tears can be either partial or complete. Men age 30 or older are the most likely to tear the biceps tendon.

What causes a tear?

The main cause of a biceps tendon tear is a sudden injury, such as trying to catch or lift a heavy object.

What are symptoms of a biceps tendon tear?

There is often a “pop” at the elbow when the tendon ruptures. Pain is severe at first, but may subside after a week or two. Other symptoms may include:

  • Swelling and pain in the front of the elbow
  • Visible bruising in the elbow and forearm
  • Weakness in bending of the elbow
  • Weakness in twisting the forearm (supination)
  • A bulge in the upper part of the arm created by the recoiled, shortened biceps muscle
  • A gap in the front of the elbow created by the absence of the tendon

How is it diagnosed?

Your doctor will review how your injury occurred. A physical examination will determine whether there is a gap in the tendon. Your physician will also test your ability to rotate your forearm against resistance and compare it to the strength of your other arm. Imaging tests, such as x-rays and magnetic resonance imaging (MRI), may also be performed to confirm a diagnosis.

How is a biceps tendon tear treated?

Treatment consists of both surgical and non-surgical approaches. Non-surgical treatment may be considered for those who are elderly and inactive, or who have medical problems that make them high-risk for modest surgery.

Surgery is the preferred treatment for most patients. It typically will take place within two to three weeks after the injury before tendons and muscles begin to shorten, hoowever it can still be done up to six weeks after the injury. There are several types of procedures to reattach the biceps tendon to the forearm, and ultimately the approach will depend upon the severity and specifics of the injury.