Bicep Tendon Pathology FAQs

Biceps tear may occur either due to sudden injury like accidental fall or lifting heavy weight or maybe due to repetitive action, especially at the shoulder joint like overhead throwing or racket games.

Patients with biceps tear may present with pain either at the shoulder or at the elbow. They will also present with weakness in lifting weight as well as reaching back of the car. These patients may also have swelling of the arm muscle in the form of popeye muscle.

Physician can get suspicious of having a biceps tear by history and physical examination. The diagnosis of biceps tear can be done by MRI of the shoulder or the elbow wherever it is suspected. There is a special protocol for elbow MRI to confirm the diagnosis if the suspicion of tear is at the elbow joint.

Patients who have a torn biceps at the shoulder or the elbow may need to undergo a surgery for repair of the torn biceps and fixing it to the bone. Usually patients will take up to six to eight weeks to recover from such a surgery. It may take another two to four weeks to regain full range of motion as in the strength in the biceps to be able to do activities as were able to do before the biceps being torn.

Biceps is usually torn in an accident or fall or when a patient is trying to lift a heavy object. It may be accompanied with a pop and sudden feeling of pain and weakness. It may also be associated with black or bluish discoloration of the skin in the area of the tear along with a bulging of the biceps called a Popeye muscle. If presenting late, these patients may have weakness and pain and may not be able to use the extremity for lifting things.

A biceps can be torn either at the elbow or the shoulder. They are treated accordingly, and the biceps torn end is fixed and repaired to the underlying bone to regain its normal anatomy and function. This is performed surgically using sutures and anchors. This is followed by immobilization and then rehabilitation to recover range of motion and strength.

Biceps, like any other tendon, if ruptured usually needs a surgical management to be repaired and fixed back. This surgery, usually done on an outpatient basis, is followed by period of rest, physical therapy and rehabilitation later to recover range of motion as well as strength.

Tendons once torn usually do not heal by themselves. Though it is not necessary that all patients who have a torn biceps need a surgical management, especially if the torn biceps tendon is at the shoulder joint. Occasionally, if a patient is in a low demand job and does not have much pain may not need surgery.

Biceps tendon is a strong muscle located on the front of the arm. It connects the shoulder to the elbow and helps in movement of shoulder as well as elbow. The either end of the muscle forma a tendon to attach itself onto the bone. The tendon is usually ruptured either at the shoulder or the elbow and is due to either an accident in which the patient may be lifting heavy weight or fall or may be due to gradual strain over time due to repetitive overactivity. These patients usually present with pain, swelling as well as limitation of movement and weakness.

Tendonitis of biceps usually involves the shoulder joint and is caused by repetitive overhead activity or lifting heavy weights. It will present in the form of pain along the front or side of the shoulder which is worsened with activities, especially overhead or lifting. It also causes night-time pain and discomfort along with awakening. These patients if not relieved by over-the-counter anti-inflammatory medications, should seek physician consultation for proper management of the problem.

Biceps may hurt after strenuous activity like lifting weight or overactivity. If this is not associated with worsening pain, swelling, black or blue discoloration, restriction of movement and weakness then patients may get better over time with the use of anti-inflammatory medication, rest, elevation, ice and compression. If the patient does not get better over 3 to 5 days, then they should seek medical attention for proper management.

Patients who have biceps tendonitis usually complain of pain and discomfort especially while performing overhead activities or lifting weights. The pain is essentially located in the front or side of the shoulder joint. It may also be associated with night-time pain and awakenings. These patients feel weak in their involved side due to pain.

A biceps is torn usually due to repetitive activities or a sudden accident that may pull the biceps. Prevention of torn biceps can be done in cases who have tendonitis and pain and they can avoid activities which cause worsening of the pain. They can also see a physician who can give medications and possibly a cortisone shot. Patient may also try physical therapy to recover function and reduce pain.

Biceps muscle is located along the front of the arm. It connects the shoulder to the elbow and helps in stability of the shoulder as well as bending of the elbow like lifting weights.

Biceps may get stretched by sudden straightening of the elbow or by lifting heavy weights beyond the capacity of the biceps muscle. It may lead to partial rupture of the muscle fibers called a pulled muscle or may lead to complete rupture of the biceps tendon at the elbow or at the shoulder.

Torn biceps can be repaired surgically in which the tendon is cleaned and fixed to the underlying bone. This is followed by immobilization and rehab to allow healing as well as recover range of motion as well as strength.

Biceps tendon is attached to the shoulder as well as to the elbow. In cases of repetitive overhead activities like sportsmen involved in basketball, baseball, volleyball, tennis there may be rubbing of the tendon causing rupture of the biceps tendon at the shoulder. In case of strenuous, sudden activity like lifting heavy weights, biceps may rupture at the elbow. This may present in the form of pain and swelling associated with black or bluish discoloration of the skin. It may also cause a bulge on the front of the arm in the form of Popeye muscle.

Patients who have biceps tear in the elbow are not good candidate for conservative treatment and usually need surgical management. Surgical management for biceps tear either at elbow or shoulder are in the form of repair and fixation of the biceps tear to the underlying bone. This helps in regaining strength as well as range of motion.

A torn biceps tendon like any other tendon, may not be symptomatic if the tear is partial and small. Tendons do not have good blood supply and do not tend to heal by its own. But a patient with partial and small tears may try physical therapy especially if the rupture is partial and may not need surgery for the same.

Patients with biceps tear usually present with pain in the shoulder or elbow associated with swelling and black or blue discoloration of the skin. They also have weakness due to inability of the muscle to help them move the extremity. They may also have restriction of movement due to pain.

Most common cause of biceps tear is gradual fraying of the tendon at the shoulder in people involved in the repetitive overhead activities like sportsmen in basketball, baseball, volleyball, tennis. It may also be caused by sudden injury like fall or lifting heavy weight.

Biceps tear at the elbow can causes inability of the arm to bend at the elbow. This can be disabling and crippling depending on the needs and demands of the patient. Patient may also have pain and swelling and may complain of night-time pain and discomfort.

Patients history as well as physical examination are usually suggestive of biceps tear. The confirmation can be done by getting an MRI of the involved area.

Biceps tears can be treated surgically as well as non-surgically. Patients with tear in the shoulder can be given a trial of non-surgical treatment in the form of rest, ice and anti-inflammatory medications. Patients can also get a cortisone injection if the biceps tear is in the shoulder. Patients can also do physical therapy to get relief from the pain and see if their function can recover without surgery.

Patients who have biceps tear in the elbow are not good candidate for conservative treatment and usually need surgical management. Surgical management for biceps tear either at elbow or shoulder are in the form of repair and fixation of the biceps tear to the underlying bone. This helps in regaining strength as well as range of motion.

Biceps tears can be treated surgically as well as non-surgically. Patients with tear in the shoulder can be given a trial of non-surgical treatment in the form of rest, ice and anti-inflammatory medications. Patients can also get a cortisone injection if the biceps tear is in the shoulder. Patients can also do physical therapy to get relief from the pain and see if their function can recover without surgery. Patients who have biceps tear in the elbow are not good candidate for conservative treatment and usually need surgical management.

Popeye sign takes its name from the cartoon Popeye, in which Popeye has a big muscle bulge in front of the arm. In patients who have rupture of biceps tendon, either at the shoulder or at the elbow, may have similar swelling on the front of the middle arm and may look like a Popeye muscle.

Distal biceps tendon rupture means rupture of the biceps tendon at the elbow. This can happen with sudden straightening of the elbow due to fall or lifting heavy weight with bent elbow. These patients develop sudden pain with swelling and black or bluish discoloration of the skin. They also have associated weakness in their elbow, especially while lifting weights.

Repetitive movements of the shoulder especially overhead like in sportsmen involved in volleyball, basketball, baseball can have inflammation of their biceps. It can also be caused by daily usual activities. This is caused by repetitive injuries to the long head of the biceps causing inflammation.

Patients who undergo biceps tendon repair usually are enrolled into physical therapy program about one week after the surgery. Some of the patients who have had biceps repair on the elbow may not need to go to physical therapy and may do home-based physical therapy program. These patients start using their arm and upper extremity starting from couple of days after the surgery. They are instructed not to lift heavy weights or to do activities like using a screwdriver in which the hand is turned repetitively, but they usually recover completely over a span of six to eight weeks’ duration.

Biceps can be torn either at the shoulder or a the elbow joint. The biceps at the shoulder can usually be repaired by fixing the torn biceps onto the humerus using screws. The biceps, if torn at the elbow, can also be repaired by fixing it to the forearm bone or radius by using sutures and endobutton. These patients usually have complete recovery of range of motion as well as strength without long-term consequences.

Distal biceps tendon rupture repair can be done in multiple ways using screws, sutures, wires or endobutton.  There are many popular methods, the recent been using screws with endobutton onto the radius bone.

Patients are allowed to use their forearm and hand a few days after the repair of biceps.  They are instructed not to lift heavy weights or to do repetitive movements involving turning of the hand.