Biceps tears and ruptures affect the biceps tendons that anchor the big muscle of your inner arm to your bones at the elbow and at the shoulder. They are either:
Shoulder biceps tears (also known as proximal biceps tendon tears) are far more common than elbow (distal biceps tendon), and chronic injuries (affecting adults over age 30) are more common than acute ones. Other causes and risk factors can include corticosteroid use, smoking, and a history of prior injuries.
Biceps tendon tears can be partial-thickness, or full-thickness. If you sustain a full rupture at either end of the biceps muscle, the muscle is then unattached at one end. Lacking one of its anchor points, the muscle may lose its tension and bunch up towards the middle of the upper arm. This will create an unnatural-looking bulge, often referred to as a 'popeye deformity', and bruising.
Men are far more likely to strain their biceps tendons than women. If you’re male and over the age of 30, be doubly mindful of the above cautions.
If you suspect a torn biceps, the first thing you need to do is visit a doctor for a diagnosis. Your doctor (preferably an orthopedist) will need to use an imaging test like an MRI to confirm a tear or rupture, although an X-ray may also be needed to rule out any injury to bone.
If you don’t have an obvious muscle bulge from a rupture, but are presenting with pain and difficulty using your arm, an X-ray may be first test your orthopedic physician uses. He or she will want to make sure you haven’t sustained a fracture.
Once you’ve had a diagnosis, options for treating a biceps tear include non-surgical treatment or surgical repair.
If you have a tear at the shoulder and the subsequent pain and reduced mobility are not severe (or they don’t bother you much), your orthopedist may say you have the option of non-surgical repair.
In this case, you’re essentially allowing the body to heal itself with the help of rest and other techniques like:
Your physician may also recommend immobilizing the shoulder and upper arm during your recovery—for example, with a sling—to sustain further damage to the tissue.
Always see a physician before deciding to use a sling. A doctor can show you the correct angle to hold your arm and can provide guidelines as to how tight the sling should be and how many hours per day you should be wearing the support device.
If your biceps tear is near the shoulder, it has more than one attachment point; therefore, unless you’ve severely torn all those tendons, you may not need surgery (elbow tears, on the other hand, are more likely to need surgical intervention).
The decision to surgically repair a torn biceps tendon depends largely on your personal tolerance for discomfort, arm weakness, deformity, and loss of range of motion. If you’re an athlete, you may be more likely to choose the surgical option so you can continue to participate in your sport. Likewise, if your job depends on full strength in your arm, surgery may be helpful.
However, if you’re an older adult (for example, past age 60), you may find you’re fine with reduced function in the arm. Keep in mind, however, that most surgeries are now minimally invasive and require only local anesthetic. Your recovery and rehab will take some time, but the surgery itself carries minimal risk and the outcomes are generally good.
What surgical procedures are available for repairing a torn biceps?
Regardless of how you intend to treat your tear or rupture, you should make an appointment to see a physician as soon as you suspect an injury—especially if you’re physically active. Letting a serious biceps tear go untreated for too long can lead to other musculoskeletal issues as you try to compensate for the pain and weakness in your arm.
If you feel that you need to be evaluated for a biceps tear contact Coastal Orthopedics in Corpus Christi, Texas today at (361) 994-1166.
Article written by: Rob Williams, MD