What is a Distal Biceps Tendon Tear?
The biceps is a muscle located in the front part of the upper arm. The proximal and distal tendons are what attach the muscle belly to the shoulder and elbow. Within this region of the upper arm, there are two groups of tendons associated with the biceps muscle. The group which attaches the biceps to the elbow (distal, or lower biceps tendon) is what this topic will focus on.
The distal biceps tendon can become injured from excessive loading or a violent force and can lead to tearing (rupture) of the tendon. Most often, this injury occurs among middle-aged men during heavy training workouts or in jobs where heavy lifting is involved. If the violent loading occurs with the elbow bent, the biceps muscle or tendon can tear.
Symptoms of a Distal Biceps Tear
- Intense pain followed by milder, throbbing pain
- An audible “pop” or a tearing sensation at the elbow
- Swelling of the biceps area at the elbow
- Bruising of the biceps area at the elbow
- Weakness in the arm
- Inability to bend the elbow or supinate the wrist
- Change in the normal contour of the upper arm (Popeye deformity)
Treatments for a Distal Biceps Tear
Treatment for torn biceps muscles varies. While nonsurgical treatment can be used, most active individuals who experience a distal biceps rupture will opt to have surgery so that full arm strength can return. Non-surgical treatment for torn biceps muscles is best suited for those who have only a partial tear or those who are very low demand in their activities. Non-surgical treatment consists of protecting the arm, resting the arm in a sling, and managing pain with common over-the-counter medications for inflammation and pain.
If the biceps tendon has torn completely, surgical repair is recommended to restore the normal anatomy and function of the tendon. Using a small open incision over the anterior elbow, a surgical technique to repair the distal biceps tendon tear is used. This is done to reconnect the tendon to the correct location on the radial bone from which it has torn. For more chronic injuries, where the tendon has retracted or become severely scarred in over time, a graft may be needed to reconstruct the torn tendon so that normal function can be restored. An MRI can help plan surgery, but the ultimate decision is made during the time of surgery to determine if a chronic tear can be mobilized enough to be repaired versus reconstructed.
Please see the video below depicting the Distal Biceps Tendon Repair surgical procedure.