Biceps Tendon Tear at the Elbow

Your biceps muscle is located on the front of your upper arm, and is attached to the shoulder and elbow via strong, fibrous tendons. A tearing of the biceps tendon at the elbow is uncommon, and is usually the result of a sudden injury. A tendon tear at the elbow will result in more arm weakness than an injury to the tendon at the shoulder.

When the biceps tendon at the elbow tears, it will not grow back to the bone and heal on its own. The other muscles in the arm make it possible to bend the elbow, but they cannot fulfill all the functions of the elbow, especially rotating the forearm.

Surgery to repair the torn tendon is typically recommended, though nonsurgical treatments are sometimes viable for those who may not require full arm function.

Description

A biceps tendon tear can be partial or complete. Partial tears damage the soft tissue, but do not completely sever the tendon. While complete tears happen when the tendon totally detaches from its attachment point on the bone.

Typically, tears of the biceps tendon at the elbow are complete, meaning that the entire muscle is detached from the bone and is pulled up toward the shoulder.

Causes

Sudden injury is the most common cause. A biceps tendon tear at the elbow is rarely associated with other medical conditions.

Injuries typically occur when the elbow is forced straight against resistance, and is less commonly injured when the elbow is forced to bend under heavy load.

Symptoms

A “pop” is commonly heard when the tendon tears, and is often accompanied by severe pain that subsides after a week or two. Other symptoms include:

• Swelling at the front-side of the elbow
• Visible bruising at the elbow and forearm
• Feelings of weakness when bending the elbow
• Weakness when twisting the forearm (supination)
• A bulge that forms in the upper part of the arm near the shoulder due to the recoiled biceps muscle
• A gap in the front-side of the elbow from the absence of the tendon

Treatment

To regain full strength and function in the affected arm, surgery to reattach the tendon is necessary.

For those who are less active or older, or if the injury happens in the non-dominant arm, nonsurgical treatment may also be an option.

• Nonsurgical treatment – This approach focuses on relieving pain and retaining as much arm function as possible. Treatment recommendations typically include rest, the use of nonsteroidal anti-inflammatory medications (NSAIDs), and physical therapy.
• Surgical treatment – Surgery should be performed 2 to 3 weeks after injury, and after that timeframe, the tendon and biceps begin to scar and shorten, meaning reattachment may not be possible. The tendon is reattached with stitches through holes drilled in the radius bone, or the tendon can be attached via small metal implants.

Your arm may be immobilized in a cast or splint following surgery, and your doctor will work with you to create a rehabilitation plan that works for you. Physical therapy and resistance exercises may be utilized during recover. The biceps tendon can take over 3 months to fully heal.

If you’ve suffered a biceps tendon tear at the elbow, our team of Board Certified Orthopaedic Surgeons will ensure that you get the care you need so that you can get back to your daily routine as quickly as possible. Request an appointment online or contact us today at 904-825-0540 to begin your journey to recovery.