What is a Biceps Tendon Tear at the Elbow?
The biceps tendons are strong fibrous cords that attach the biceps muscle to the bone. The biceps muscle is the muscle at the front of the upper arm that allows you to pull your hand toward your shoulder.
The biceps muscle has two tendons that attach at the shoulder and one at the elbow.
The biceps tendon that attaches at the elbow is also known as a distal bicep tendon. A distal biceps tendon tear is as common as a proximal biceps tendon tear, which occurs at the shoulder. A torn distal biceps tendon often occurs because of a sudden injury. These types of tears usually cause greater arm weakness than a biceps tear at the shoulder.
What Are the Symptoms of a Biceps Tendon Tear?
A distal biceps tendon rupture is often first noticed by a popping sound. You will also feel intense pain in the front of your arm. Other symptoms of a distal biceps rupture include the following:
- Swelling in the inside of your elbow
- Bruising in your elbow and forearm
- Weakness when bending your elbow
- Weakness twisting your forearm (supination)
- A bulge in the front of your arm
- A gap in the front of the elbow where the tendon once was
The Cause of Distal Biceps Tendon Ruptures
Tears of the distal tendon usually occur through sudden injury as the elbow is forced straight under load. This could happen while lifting a heavy object or as a result of a sports injury. In some rare cases, the biceps tendon tears when the elbow is forcibly bent under load.
Who is at Risk?
Men are more likely than women to tear their distal biceps tendon. Men are more likely to tear their distal tendons at 30 years of age or over. Additional risk factors include the use of steroid medications and smoking, which both can weaken the tendons.
How is an Elbow Bicep Tendon Tear Diagnosed?
Diagnosing a distal biceps tear involves a thorough physical examination and, if needed, imaging tests. During the physical exam, the doctor checks for a gap in the tendon and assesses forearm supination strength, comparing it to the uninjured side.
Imaging tests, such as X-rays, ultrasound, and MRI, may be used to confirm the diagnosis. X-rays help rule out other causes of elbow pain, while ultrasound can reveal the recoiled biceps tendon. An MRI can provide detailed images of soft tissues, detecting partial or complete tears. Additional imaging tests may be unnecessary if the tear is evident during the physical examination.
How to Treat Distal Biceps Ruptures
Treating a distal bicep tendon tear involves both surgical and non-surgical approaches. If you would like to return to full strength and function, then surgery is necessary. However, non-surgical options may be considered for older or less active individuals, those with medical complications, or those unable to commit to post-surgery rehabilitation.
Non-surgical Treatments
The purpose of non-surgical treatments is to relieve pain and maintain the function of your arm. Resting your arm by using a sling, as well as NSAIDs such as ibuprofen, can help alleviate pain and reduce swelling. Physical therapy can help strengthen the surrounding muscles to maintain arm movement and function.
Surgery for Bicep Tendon Tears
Surgery to repair the torn tendon is most often done during the first 2 to 3 weeks after injury. If the surgery is left longer, the biceps muscle can shorten and scar, making it difficult to restore function.
During surgery, your doctor will reattach the distal biceps tendon to the bone.
Post-Surgery Recovery
Following surgery, your arm may be immobilized with a cast or splint. Soon after, your doctor will introduce movement, often with a protective brace. They may also recommend physical therapy to restore range of motion and strength.
Your rehabilitation plan may include gentle resistance exercises,to aid in recovery. Biceps tendon tears require more than 3 to 4 months to fully heal, so you shouldn’t over-exert yourself. Always follow your physical therapist’s instructions.
Key Takeaways
- A distal biceps tendon tear occurs when the tendon connecting the biceps muscle to the elbow bone is damaged, resulting in symptoms such as pain, swelling, weakness, and a visible gap or bulge in the arm.
- Distal biceps tendon tears typically result from sudden injury or trauma, such as lifting heavy objects. Men over 30 are at higher risk, along with individuals using steroid medications or smoking, which weaken tendons.
- Treatment includes surgical and nonsurgical approaches. Surgery is recommended for those seeking full strength and function restoration, ideally performed within the first 2 to 3 weeks post-injury. Nonsurgical options may be suitable for specific cases, focusing on pain relief, rest, NSAIDs, and physical therapy to maintain arm function.
Schedule Your Appointment Today
Schedule a consultation with Georgia Hand, Shoulder & Elbow today for personalized and effective orthopedic care. Let our experienced team in Marietta and Atlanta, GA, help you on your road to recovery. Contact us now!
