Biceps Tendon Tears

Biceps Tendon Tears


The bicep muscle has two tendons. One tendon with two heads attaches the bicep muscle to the shoulder at two places on the scapula or shoulder blade (Proximal biceps tendon). The proximal biceps tendon is part of the rotator cuff. The other attaches the muscle to the elbow (Distal biceps tendon).

The biceps muscle controls the ability to bend and rotate the forearm and allows the ability to pull and lift. The tendon can tear in either location. A tear may be complete or partial. A complete tear means the muscle is detached from the bone. A partial tear means the tendon has been damaged and is at risk of tearing or has not completely detached from the bone.

What causes a biceps tendon tear?

  • Overuse – repetitive movements of the shoulder or elbow.
  • Traumatic injury that causes movement or twisting at the elbow as when falling on an outstretched arm.
  • Heaving lifting is the most common cause of a tear at the elbow.

Who is at risk?

  • People who play sports that involve throwing like baseball
  • Players who don’t warm up before play
  • People with a previous shoulder or upper arm injury

What are the symptoms of a biceps muscle tear?

  • At the time of the injury there may be a popping sound
  • A sharp pain at the location of the tear
  • A bruise on the arm or forearm
  • Shoulder or elbow weakness
  • Helpless inability to move or rotate the arm
  • A change in the contour of the biceps muscle that makes the muscle appear more prominently like Popeye!
  • Muscle spasms

How is a biceps muscle tear diagnosed?

Your Ortho Illinois board-certified orthopedic surgeon will discuss your symptoms and medical history. Then they will conduct a physical examination and look for other injuries that often accompany a biceps tear including rotator cuff injuries and shoulder impingement. A complete tear may be obvious because of the appearance of a bump on the upper arm. Imaging tests will likely be ordered to rule of other injuries and to determine the severity of the tear including x-rays or an MRI.

How is a bicep tear treated?

Proximal biceps tears.

The bicep tendon has two heads, the long head and the short head. The proximal bicep tendon attaches the muscle to the shoulder. The long head is the most common area for a tear. When the long head is torn completely or partially, the short head may continue to allow use of the muscle. However, continued use can damage the shoulder causing catching or locking of the shoulder joint.

Nonsurgical treatment including rest, anti-inflammatory medications and physical therapy may be recommended as a first-line approach to relieve symptoms when there are no additional injuries to the shoulder.  When nonsurgical treatment fails to relieve symptoms, and the cosmetic appearance is unacceptable, surgery is the answer. Recovery with nonsurgical treatment can take up to 4-5 months before return to normal activity.

Surgical repair of the long head of the tendon is safe and offers a quick return of function and with physical therapy, a return of strength. Additionally, when the patient experiences a tear and desires to return to play surgery will be the treatment of choice.

Distal biceps tears.

When the tear is near the elbow, surgery to restore range of motion and strength will be necessary even though movement may be possible.  Surgical repair must be accomplished within a few weeks of injury because scarring of the tendon and muscle can make surgery more difficult and result in muscle atrophy.

After surgery, the arm will be immobilized with a cast or splint for 4-6 weeks, followed by physical therapy to regain range of motion and strength. It can take up to a year after surgery for full recovery.

When you have a bicep tendon tear it could be serious. You need an orthopedic surgeon you can rely on. Early diagnosis and treatment are the key to successful recovery. At Ortho Illinois we provide an unsurpassed continuum of care by a team of specialized surgeons, physiatrists and physical and occupational therapists focused on your successful surgery and recovery. Ortho Illinois has offices in Algonquin, Elgin, Rockford/Riverside, and Rockford/Roxbury for your convenience. Contact us to schedule a consultation at 815-398-9491 and the get right diagnosis and treatment.