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Distal Biceps Tendon Rupture




The biceps muscle is in the front of your upper arm. It helps you bend your elbow and rotate your forearm. The tendon portion near the shoulder helps with shoulder stabilty.


Your biceps tendons attach the biceps muscle to bones in the shoulder and in the elbow. If you tear the biceps tendon at the elbow, you will lose flexion strength in your arm and be unable to forcefully turn your forearm outward.  Also, you will have a deformity of the muscle belly when you try and flex your muscle.


Once torn, the biceps tendon at the elbow will not grow back to the bone and heal. Other arm muscles make it possible to bend the elbow fairly well without the biceps but they cannot fulfill all the functions. Significant, permanent weakness during forearm rotation and elbow flexion will occur if this tendon is not surgically repaired.


How do you tear your distal biceps?


Usually the biceps tendon tears when the elbow is forced straight against resistance or when lifting an object that is too heavy.  You try and keep your arm bent against the force but the stress in the biceps increases and the tendon tears.


What are the symptoms of a distal biceps tendon tear?


You may feel a “pop” at the elbow with immediate pain.  Other symptoms may include swelling in the front of the elbow, bruising in the elbow and forearm, and weakness in bending of the elbow and twisting the forearm.  You may have a bulge in the upper part of the arm created by the recoiled, shortened biceps muscle or a gap in the front of the elbow created by the absence of the tendon.


How do you diagnose a distal biceps tear?


Your physician will discuss your symptoms and perform a detailed physical exam.  In addition, your physician may order further imaging studies like an X-ray or MRI to confirm the diagnosis.


How do you treat a distal biceps tear?


Nonsurgical treatment may be considered for elderly or inactive people or those whose medial problems make them high-risk for surgery.


For surgical repair, the tendon should be repaired during the first 2 to 3 weeks after injury. After this time, the tendon and biceps muscle begin to scar and shorten.  This may make the surgery more complicated and less successful.


There are several surgical procedures options, all with good results, to repair the biceps tendon, using one or two-incisions, and anchors or drill holes through the bone, to secure the tendon back to the bone.

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Distal Biceps Tear
Distal Biceps Repair (courtesy Arthrex)
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