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Orthopaedic Services

Biceps Tendon Injuries and Ruptures

The biceps is one of the main muscles that bend the elbow. The biceps muscle is attached to the humerus above the elbow, and the biceps tendon joins onto the radius below the elbow. Bicep tendon injuries include tendonitis and bicep tendon tears or ruptures. A rupture of the bicep tendon occurs when the tendon pulls off the radius. This usually happens when catching a falling object or when lifting something heavy.

When it occurs, there is often an audible "pop" as it ruptures. This is accompanied by sudden pain, and the biceps shortens as the tendon pulls off the bone and comes to lie above the elbow. The biceps contracts into a ball and is referred to as a "Popeye muscle". Occasionally there is a partial tendon injury where some tendon is still attached to the bone. When this happens, the muscle usually does not change shape. Once the tendon pulls away from the bone, it cannot heal itself.

People who have bicep tendon injuries, bicep tendon tears or ruptures experience symptoms such as swelling in the front of the elbow, bruising in the elbow and forearm, and weakness when bending and twisting the elbow and forearm. A bulge may form in the upper part of the arm due to the recoiled, shortened biceps muscle and there may be a gap in front of the elbow due to the absence of the tendon.

Repair of the injury requires surgery to reattach the tendon onto the bone. This involves the orthopaedic surgeon restoring the shape of the muscle and the strength back to normal. If this injury occurs in someone who is very low demand and sedentary, surgery may not be required, but there will be a persistent weakness, and the shape of the muscle will remain shortened.

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