What Is Biceps Tendon Rupture?
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Biceps Tendon Rupture - Types, Causes, Symptoms, Diagnosis, and Management

Published on Dec 23, 2022 and last reviewed on Jun 29, 2023   -  5 min read


Biceps tendon rupture occurs due to a sudden injury that leads to arm weakness. To know more, read below.


Biceps tendons help attach the biceps muscles to the shoulder and elbow bones. When a tear occurs in the shoulder tendon, the arm loses its strength and has pain during forceful movement of the arm during palm up and palm down. However, most people still function at a high level with a shoulder tendon tear and require only simple treatment to relieve pain.

What Is the Anatomy of the Biceps Tendon?

  • The shoulder is a ball and socket joint made up of three bones- the upper arm bone, shoulder blade, and collar bone.

  • The head of the upper arm bone fits into the rounded socket in the shoulder blade. This is called the glenoid socket.

  • The muscles and ligaments (connect bone and muscles) are called rotator cuffs- keep the arm bone centered in the shoulder socket and attach it to the shoulder blade.

  • The upper end of the biceps muscle has two tendons that help in attachment to the shoulder bone.

  • The long head attaches to the shoulder socket, whereas the short head attaches to the bump on the shoulder blade.

What Are the Types of Biceps Tears?

Partial Tear: Partial tears will not completely sever the tendon.

Complete Tear: The complete tear will split the tendon into pieces.

Why Is the Biceps Tendon More Likely to Be Injured?

The biceps tendon is more vulnerable as it travels through the shoulder joint to the attachment point in the socket. The short head of the biceps tendon rarely tears because of the second attachment. Even though the long head of the biceps tendon tears completely, the person can use the biceps.

What Are the Causes?

The First cause that mostly cause this condition is injury. Falling on a hard outstretched arm and lifting something too heavy results in a biceps tear. Another cause of this condition is overuse of the biceps tendon. Aging results in the wearing down and fraying of the tendon. It can be worsened by overuse.

What Are the Risk Factors?

What Are the Symptoms?

  • Sharp pain in the upper arm.

  • Pain is of sudden onset.

  • Audible popping sound.

  • Cramping of the biceps muscle.

  • Pain and tenderness of the shoulder and elbow.

  • Difficulty in turning the hand.

  • A bulge in the upper arm above the elbow.

How to Diagnose?

  • A thorough medical history is obtained by the physician before examining the person.

  • To diagnose the partial ruptures, the physician will ask to bend the arm and tighten the biceps muscle. The presence of pain indicates a partial tear.

  • The biceps tear may also occur near the elbow, which causes a gap in front of the elbow. The physician will check the arm for damage to this area.

  • The provocative tests include the hook test and Ruland biceps squeeze test.

  • In the hook test, the physician will use the index finger to hook around the lateral edge of the biceps tendon with the elbow flexed and in the supination position.

  • If the physician can hook the finger one centimeter underneath the tendon, then the test is positive, and the tendon is intact.

  • In the Ruland biceps squeeze test, the elbow is supported in sixty to eighty degrees of flexion, and the forearm is downward. The physician will squeeze the distal biceps muscle belly. The test is positive when there is no supination (facing upward) of the forearm and wrist.

  • Other investigations include X-rays and magnetic resonance imaging.

What Is the Treatment?

Non-surgical Treatment:

  • Rest: Should take proper rest to relieve pain and swelling. Physicians may recommend using a sling to avoid pressure on the arm.

  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Anti-inflammatory drugs like Ibuprofen can reduce pain which should be taken under physician advice.

  • Physical Therapy: Once the individual recovers from pain, the physician recommends rehabilitation exercises to strengthen the muscles and restore function and movement.

Surgical Treatment:

  • Surgery should be done during the first two to three weeks after the injury whereas three weeks after injury, the tendon and biceps muscle begin to scar and shorten, and it is impossible to restore the function through surgery.

  • The aim of the procedure is to reattach the distal biceps tendon to the forearm bone.

  • The procedure involves an incision on the front of the elbow and sometimes an incision placed on the front and back of the elbow.

  • One method to attach the tendon is with stitches through holes drilled into the radius bone. Another method is using small metal implants.

What Are the Complications of Surgery?

  • Numbness and weakness in the forearm, wrist, and hand can occur, which usually goes away.

  • New bone formation occurs around the site where the tendon is attached to the forearm bone, which causes a limitation of movement and reduces the ability to twist the forearm.

  • Rupture of the tendon may occur even after full healing.

When to Start Rehabilitation Exercises?

  • Soon after surgery, the individual's hand is stabilized with a splint or cast.

  • The physician will soon start with the movement of the arm with the protection of the brace.

  • Physicians also prescribe physical therapy to regain the range of motion and strength.

  • Rehabilitation exercises are added gradually, which include the use of elastic bands and contracting the biceps lightly.

  • Usually, biceps tendon tears take three to four months to heal; the individual must follow the physician's advice.

  • Light activities can be started after surgery, while lifting heavy objects should be avoided for several months.

What Is the Outcome of the Surgery?

Almost all individuals will perform a full range of motion and strength at the final doctor visit. After a period, the individual can resume their regular activity and jobs.


The key to preventing this injury is to educate the individual on modifying the risk factor, such as discontinuation of smoking and stretching before physical activity. Once the injury is diagnosed, work-specific and sport-specific training is recommended before resuming their regular activity. The complete recovery occurs within eight to twelve weeks.

Frequently Asked Questions


Can a Torn Bicep Tendon Heal by Itself?

A bicep tendon injury may take some time but can heal on its own in some cases. The healing of muscle takes around two to three months, but the patient can do other daily activities within the period of two to three weeks. During the healing phase, patients are advised to avoid any strenuous activities like heavy lifting, which can also worsen the condition.


What Is the Treatment for a Rupture Bicep Tendon?

Patients with rupture bicep tendons rarely require any surgical treatment. However, without any treatment, some of the symptoms, like cramping of muscle or muscle pain, may develop. Surgery is required in the case of athletes who require complete recovery. Moreover, some of the following things can help in fastening the recovery which includes -
- Cold packs or ice to reduce the swelling.
- Nonsteroidal anti-inflammatory medications to relieve swelling and pain.
- Resting is an essential part of complete recovery.
- Avoiding lifting heavy objects.


Can the Bicep Tendon Tear Fully Grow Back?

Bicep tendons are attached to the bones of the shoulder and elbow. These tendons are strong rods of fibrous tissues that attach the muscles to the bones. Once these tendons are torn off or damaged at the elbow, they will not grow back to the bone. However, some surgical procedures may help to treat this condition, depending on the severity.


Can A Person Live With a Torn Bicep?

The tendon can tear partially or completely, and the majority of people with this injury can lead a normal life. The patient may not even require any surgical treatment for this condition. However, this may cause some problems in the mobility of the shoulder, and the strength of the injured arm may also decrease. But this does not affect the person from doing daily activities.


Can Tendons Heal on Their Own?

Minor tendon and ligament injuries may heal on their own. However, injuries that may cause severe pain or may affect the daily life of a person may require treatment. Moreover, activities like stretching and flexibility exercises can also help in repairing the tendon completely and relieving the pain.


How Successful Is Bicep Tendon Surgery?

Bicep tendon surgery is a common surgical procedure that usually does not cause any complications after surgery. The surgical approach for torn bicep tendons is based on the severity of the condition, such as single or double incisions. This surgery usually has a high success rate, and patients can return to activities like sports.


What Happens if a Torn Bicep Is Left Untreated?

If the torn bicep injury is left untreated, it may lead to a loss of strength in the forearm, and the patient also feels weakness while bending the elbow. The injured arm will have a less than 30 to 40 percent decrease in strength, and in some cases, without any treatment, it may cause permanent weakness. 


Is Bicep Tear Surgery Painful?

Bicep tear surgery is a normal procedure and does not involve any risks. The pain during the surgery depends upon the type of medicine taken during the surgery, which will help in making the arm numb, and anesthesia is used for this surgery. The numbness goes away after 12 to 24 hours, and the stitches and bandages will be placed. The patient may have some pain and discomfort after surgery, for which some medicines can be taken to relieve swelling and pain.


What Are the Risks Associated With Bicep Surgery?

Every surgical procedure involves some risks, and bicep tendon surgery is also no different. Usually, this surgery has a high success rate and does not cause any complications. However, there are some risks involved with this surgery, such as:
- Infection.
- Stiffness of elbow.
- Numbness in the forearm. 
- Injury to a nerve leading to weakness in the wrist.


Can a Repaired Tendon Tear Again?

Tendon repair surgeries are commonly performed procedures and involve minor risks, and one of them is the tearing of the repaired tendon. In about every one in 20 tendon repair surgeries, the treated tendon may tear or rupture again. This is usually seen after the surgery when the tendon is weak. This also occurs when patients do not follow the doctor's advice of resting the repaired tendon.


When Can a Person Lift Weights After Bicep Surgery?

If a patient lifts or does heavy exercises before the bicep injury, they may be able to commence these activities after the time of two to three months, depending on the severity of the injury. Heavy lifting is usually advised after the time of six months. The low-lisk activities can be performed in about three months, such as playing sports and training.


What Type of Doctor Fixes Torn Biceps?

In case of torn bicep injury, the patient may get in contact with a physical therapist, and he can either refer to an orthopedic surgeon or patient can directly contact an orthopedic surgeon. After assessing the injury, they may advise the patient to do any physical activity to strengthen muscles and may advise to wear a sling to rest the injured arm, depending upon the type of injury. 

Last reviewed at:
29 Jun 2023  -  5 min read




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