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Biceps Tendon Injuries

An Overview on Biceps Tendon Injuries

A bicep tendon tear can be related to a shoulder injury or an elbow injury. The biceps muscle is found at the front of the arm and plays an important role in flexing the elbow and rotating the wrist. The biceps tendons attach the biceps muscle to the bones in the shoulder and the elbow. If a bicep tendon tear occurs from a sports injury, fall or extreme wear and tear, bicep tendon pain will become present and strength in the upper arm will become lost. Chicago, Westchester, Oak Brook and Hinsdale, Illinois area shoulder specialist, Dr. Nikhil Verma helps patients return to activities following biceps tendon injuries.

A bicep tendon tear can happen at the shoulder or the elbow. The tendons may become frayed or eventually tear at their attachment site. There are two varieties of a bicep tendon tear, including:

  • A partial tear that does not completely sever the tendon
  • A complete tear that tears the tendon completely away from the bone

The majority of tears are caused by continuous wear and tear and strain on the biceps muscle and tendon. Tears occur in two ways:

  • At the shoulder joint: A proximal biceps tendon tear is an injury to the biceps tendon as it enters the shoulder joint. This injury is frequently associated with rotator cuff injuries and is common in adults over 60 years of age.
  • At the elbow joint: A distal biceps tendon tear occurs at the elbow joint and a loud “pop” is common when the tendon tears. This injury is common in middle-aged men involved with heavy lifting and sports.

Symptoms of a Bicep Tendon Tear

The most prevalent symptom of a bicep tendon tear is bicep tendon pain. The pain will be sudden and severe in the affected area. Other symptoms include cramping, bruising, tenderness and a “popping” sound or snap. In addition, most people will notice of deformity of the biceps causing bulging often referred to as a “popeye” deformity. This may be accompanied by bruising.

Diagnosis of a Bicep Tendon Tear

Dr. Verma typically orders an MRI if a patient believes they experienced a tear. A physical exam will normally provide tear evidence, and the MRI confirms the tear.

Treatment of a Bicep Tendon Tear

The biceps has two attachments at the shoulder joint, a long head and a short head. The long head attaches directly to the labrum and passes inside the actual shoulder joint. Short head biceps injuries are rare, while long head biceps injures are common. Since there are two attachment sites, many patients can still function with a bicep tendon tear and will only need simple treatments to alleviate bicep tendon pain.


A partial or minor tear can be treated with ice, rest and anti-inflammatory medications in many cases. Patients are advised to avoid heavy lifting and strenuous activity while the tear attempts to heal. Physical therapy is recommended to gain back strength and flexibility.


A bicep tendon tear may be surgically repaired depending on patient age, activity level and severity of the injury. Bicep tendon injuries can be repaired with arthroscopic shoulder surgery and minimal incisions. The goal of the shoulder surgery is to re-anchor the torn tendon back to the bone. If a small portion of the tendon is damaged, shaving the torn fibers (debridement) may be utilized. If a large portion of the tendon is damaged, the torn tendon stump may need to be removed from inside the shoulder joint and then reattachment of the remaining tendon to the bone in the upper arm needs to be completed by the use of a biceps tenodesis.

Tears that occur at the elbow almost always require surgery to restore the integrity of the tendon and function of the muscle. The surgery is generally recommended within two weeks of the injury. During surgery, a small incision is made in the front of the elbow and the tendon re-attached to the bone using a button. After surgery the arm is immobilized in a splint for 4 weeks with general return to all activities by 12 weeks.

For more information on bicep tendon tears or other biceps tendon injuries, please contact the orthopedic office of Dr. Nikhil Verma, shoulder specialist serving patients living in the communities of Chicago, Westchester, Oak Brook and Hinsdale, Illinois.

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