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Bicep Tendon Repair

The biceps muscle is present on the front side of your upper arm and functions to help you bend and rotate your arm.

The biceps tendon is a tough band of connective fibrous tissue that attaches your biceps muscle to the bones in your shoulder on one side and the elbow on the other side.

Overuse and injury leads to fraying of the biceps tendon and eventual rupture.

A Biceps tendon rupture can either be partial, where it does not completely tear the tendon, or complete, where the biceps tendon completely splits in two and is torn away from the bone.

The Biceps tendon can tear at the shoulder joint or elbow joint. The majority of bicep tendon ruptures occur at the shoulder and is referred to as proximal biceps tendon rupture. When it occurs at the elbow it is referred to as a distal biceps tendon rupture, however this is much less common.

Causes

Biceps tendon ruptures occur most commonly from an injury, such as a fall on an outstretched arm, or from overuse of the muscle, either due to age or from repetitive overhead movements such as with tennis and swimming.

Biceps tendon ruptures are common in people over 60 who have developed chronic micro tears from degenerative changes and overuse. These micro tears weaken the tendon making it more susceptible to rupturing.

Other causes can include frequent lifting of heavy objects while at work, weightlifting, long term use of corticosteroid medications and smoking.

Symptoms

The most common symptoms of a biceps tendon rupture include:

  • Sudden, sharp pain in the upper arm
  • Audible popping sound at the time of injury
  • Pain, tenderness and weakness at the shoulder or elbow
  • Trouble turning the arm palm up or down
  • Bulge above the elbow (popeye sign)
  • Bruising to the upper arm

Diagnosis

Your doctor diagnoses a biceps tendon rupture after observing your symptoms and taking a medical history. A physical exam is performed where your arm may be moved in different positions in order to see which movements elicit pain or weakness. Imaging studies such as X-rays may be ordered to assess for bone deformities such as bone spurs, which may have caused the tear or an MRI scan to determine if the tear is partial or complete.

Treatment

Nonsurgical Treatment: Nonsurgical treatment is an option for patients whose injury is limited to the top of the biceps tendon.

Nonsurgical treatment includes:

Rest: A sling is used to rest the shoulder and you are advised to avoid overhead activities and heavy lifting until healed.

Ice: Applying ice packs for 20 minutes at a time, 3 to 4 times a day, helps reduce swelling.

Medications: Non-steroidal anti-inflammatory medicines help reduce pain and swelling.

Physical therapy: Strengthening and flexibility exercises help restore strength and mobility to the shoulder joint.

Surgical Treatment

Surgery may be necessary for patients whose symptoms are not relieved by conservative measures and for patients who require full restoration of strength, such as athletes.

Your surgeon makes an incision either near your elbow or shoulder, depending on which end of the tendon is torn. The torn end of the tendon is cleaned and the bone is prepared by creating drill holes. Sutures are woven through the holes and the tendon to secure it back to the bone and hold it in place. The incision is then closed and a dressing applied.

Risks and Complications

As with any surgery, complications can occur related to the anesthesia or the procedure. The majority of patients suffer no complications following biceps tendon repair, however, complications can occur and may include:

  • Infection
  • Nerve damage
  • Re-rupture of the tendon

Our Providers: Shoulder and Elbow Specialists

  • John Baker, MD

    John Baker, MD

    Practice Name

    Orthopedic Surgery
    • Knee
    • Shoulder
    • Sports Medicine
  • Wayne Z. Burkhead, MD

    Wayne Z. Burkhead, MD

    Practice Name

    Orthopedic Surgery
    Total Joint Replacement
    • Shoulder
    • Shoulder Replacement
    • Sports Medicine
  • Daniel E. Cooper, MD

    Daniel E. Cooper, M.

    Practice Name

    Orthopedic Surgery
    • Knee
    • Shoulder
    • Sports Injuries
    • Sports Medicine (10 years and older)
  • Kurt Kitziger, MD

    Kurt Kitziger, MD

    Practice Name

    Orthopedic Surgery
    Total Joint Replacement
    • Hip Replacement
    • Anterior Hip Approach
    • Posterior Hip Approach
    • Shoulder Replacement
    • Hip Injuries
    • Knee Replacement
    • Knee Injuries
    • Sports Medicine (5 years and older)
  • Todd Moen, MD

    Todd Moen, MD

    Practice Name

    Orthopedic Surgery
    • Elbow
    • Knee
    • Shoulder
    • Shoulder Replacement
    • Sports Medicine
  • Mark Muller, MD

    Mark Muller, MD

    Practice Name

    Orthopedic Surgery
    Total Joint Replacement
    • Hip
    • Hip Replacement
    • Knee
    • Knee Replacement
    • Shoulder
    • Shoulder Replacement
    • Sports Medicine (5 years and older)
  • James R. Sackett, MD

    James R. Sackett, MD

    Practice Name

    Orthopedic Surgery
    • Sports Medicine (Birth -13 years)- Club Feet, Sports Injuries
    • Sports Medicine (Birth-18 years)- Fractures, Hip, Knee, Scoliosis, Shoulders
    • Sports Medicine (13 years – 18 years)- Ankle, Foot, Forearm, Wrist, Wrist Fractures
  • Daniel Worrel, MD

    Daniel Worrel, MD

    Practice Name

    Orthopedic Surgery/Total Joint Replacement
    • Elbow
    • Elbow Replacement
    • Knee
    • Knee Replacement
    • Shoulder
    • Shoulder Replacement
    • Sports Medicine (13 years and older)
    • Wrist Fractures
  • Thomas Diliberti, MD

    Thomas Diliberti, MD

    Practice Name

    Orthopedic Surgery
    Total Joint Replacement
    • Elbow
    • Elbow Replacement
    • Finger
    • Forearm
    • Hand
    • Joint Finger Replacement
    • Sports Medicine (7 years and older)
    • Wrist
  • Megan M. Wood, MD

    Megan M. Wood, MD

    Practice Name

    Specialty & Sub-Specialties

    Orthopedic Surgery
    • Elbow
    • Hand
    • Wrist
    • Fractures
    • Sports Medicine
    • Treats all ages (birth-adult)