Biceps tendon rupture at the elbow is also called a distal biceps tendon rupture- it is an injury causing the attachment of the biceps brachii tendon to separate from the bone or cause the tendon to tear.
Symptoms
- Pain
- Loss of range of motion particularly in elbow flexion and turning the palm up (supination)
- Hearing or feeling a “pop”
- Weakness elbow and shoulder flexion as well as supination
- Cramping of retracted muscle
- Bulge in arm where muscle has rolled up
- Bruising where tendon is torn or at attachment at the radial tuberosity in the forearm
- Swelling in the front of the arm
- Deformity-gap in front of the elbow where the tendon should be
Causes
- Sudden injury causing excessive extension of the elbow against resistance
- An unexpected force placed on the hand (distal end) when elbow is in flexed position
- Fairly uncommon injury
Risk factors
- Lifting a heavy load
- Occurs more often in men than women
- Most often occurs in those over the age of 30
- Smoking
- Corticosteroid injection
- Anabolic steroids
Prevention
- Maintain proper strength of shoulder, elbow, and forearm
- Avoid lifting heavy objects
- Avoid steroid use and smoking
- Be careful picking up heavy loads as well as lowering them to the ground
Diagnosis
- Physician examination in which the physician will look for obvious signs of deformity, such as a gap in the tendon, as well as testing strength in elbow flexion and supination
- X-ray to rule out avulsion fracture
- MRI or video ultrasound to determine extent of damage to tendon- can be a full tear or partial tear
Treatment options
Non-surgical
- Non-surgical treatment possible if there is a partial tear (not a full tear), on older and inactive adults, or in a non-dominant arm when the individual is alright without full function
- Rest –no heavy lifting or overhead activities
- Non-steroidal anti-inflammatory medications
- Physical therapy to relieve pain and maintain function
- Sling if necessary for healing
Surgical- bicep tendon repair
- Surgery usually recommended in distal bicep tendon ruptures due to the singular attachment site
- Open outpatient procedure where the ruptured tendon is repaired with sutures or with an anchor and sutures
- Usually performed 2-3 weeks after the initial injury
- Approximate 3 month post-surgery healing process
