Colorado Orthopedic News

Bicep Tendon Tear

Bicep Tendon Tear

Weakness, muscle fatigue, pain, and deformity can all happen with bicep tendon tears. A bicep tendon tear can happen at the shoulder or the elbow, making diagnosis and treatment a more complex issue. This is why it is so important to seek immediate help from the skilled, experienced orthopedic specialists at OCC – Advanced Orthopedics & Sports Medicine Specialists in Denver, Parker, or Aurora. Whether the tear is in your shoulder or elbow, you can’t afford to let these injuries keep you from being able to function the way you need to.

OVERVIEW

A bicep tendon tear is a tear or break in the tendon that connects the biceps muscle in the upper arm to the shoulder or elbow. A biceps tendon tear can happen suddenly or gradually. For example, in many cases, torn biceps tendons begin by fraying. As the damage progresses, the tendon can completely tear. Biceps tendon tears can be either partial or complete: partial, where the tear doesn’t completely sever the tendon, or complete, where the tendon splits into two pieces. These tears commonly occur in the dominant arms of adults between the ages of 40 and  60. 90% of biceps tendon tears happen at the shoulder.

ABOUT THE BICEPS MUSCLE

The bicep muscle is well known to most people as the muscle that forms the shape of the anterior (front) surface of the upper arm and is often the prominent muscle for flexing the elbow. It is more prominent in males because muscle hypertrophy (bulk) is greater in a male’s anatomy due to the level of testosterone, but with the increase in the prevalence of weight training in females, the biceps tendon/muscle is easily visualized on the thinner and fitter women. Tendons are bands of fibrous tissues that have the property of being tough as well as flexible. Three tendons attach the bicep to the bone:

  • The long head tendon attaches the bicep to the top of the shoulder socket
  • The short head tendon attaches the bicep to a bump on the shoulder called the coracoid process
  • The third tendon attaches the bicep to the radius, one of the forearms’ bones.

Any of these three bicep tendons can tear.

WHAT ARE SHOULDER BICEP TENDON TEARS?

Location: The biceps tendon in the shoulder has two attachment points—the long head and the short head. Tears often occur at the long head, which attaches to the top of the shoulder socket (glenoid) within the shoulder joint. 96% of tears happen to the long head tendon.

Symptoms: Pain in the front of the shoulder, weakness, and sometimes a noticeable bulge or deformity (known as a “Popeye deformity” as the bicep muscles may bunch up.

Causes: An injury to the long head tendon is more likely from overuse and repetitive motion that fray the tendon or from a sudden acute injury like a fall. These injuries are common in sports like tennis, swimming, weightlifting, and football. Aging and natural degeneration are also common causes.

Non-surgical treatment: May include rest, physical therapy, and anti-inflammatory medications.

When is surgery indicated? Surgery may be a choice for those who continue to experience symptoms or have had a “Popeye deformity” repaired. Surgery can return nearly all arm strength and function, and a re-tearing of the repaired tendon is uncommon.

WHAT ARE ELBOW BICEP TENDON TEARS?

Location: While two tendons attach the biceps muscle to the bone at the shoulder, only one tendon attaches it to the elbow. The biceps tendon in the elbow attaches to the radius bone, specifically to the radial tuberosity. Tears in this region are less common than shoulder tears.

Symptoms: Pain in the front of the elbow, particularly when bending or rotating the forearm, weakness, and sometimes a visible gap in the upper arm when the biceps muscles contract.

Causes: A bicep tendon tear at the elbow usually happens when the elbow is pushed straight against a heavyweight. Overuse, repetitive activities, or sudden forceful movements can lead to tears. It may also be associated with other elbow injuries or conditions. Men aged 30 and older are most likely to tear the distal biceps tendon.

Non-surgical treatment: Conservative measures such as rest, ice and physical therapy should be the first measure of treatment.

When is surgery indicated? Because of the inability to fulfill all elbow functions, many people opt for surgery to restore normal strength and avoid permanent disability. Surgery should be performed during the first 2 to 3 weeks after injury. After this time, the tendon and biceps muscles begin to scar and shorten, and it may not be possible to restore arm function.

GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.

Because of the dual nature of biceps tendon tears, it is critical to be evaluated correctly in order to arrive at the proper plan of treatment. The skilled orthopedic specialists at Advanced Orthopedics in Denver, Parker, or Aurora, Colorado, have years of experience treating these kinds of injuries. After a detailed medical history and thorough examination, imaging studies may be requested such as X-rays, ultrasounds, or MRIs. While X-rays do not directly show soft tissues like tendons, they can rule out other potential issues such as fractures or arthritis. Because ultrasounds can visualize soft tissues, it can help assess if there is a tear. An MRI can provide a more detailed image of soft tissues, not only to help identify tears but to assess the severity of the injury. In some cases, an arthroscopic examination may be performed. This involves inserting a small camera through tiny incisions to directly visualize and assess the condition of the biceps tendon. Whatever it takes, you can trust the caring professionals at Advanced Orthopedics to pinpoint your exact problem and develop a treatment plan that will relieve your shoulder or elbow pain and get your arm functioning to its full strength so that you can function in your everyday activities. If you think you might have a bicep tendon tear, schedule an appointment today.

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