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Biceps Tendon Tear at the Elbow

The biceps muscle is in the front of your upper arm (humerus).  It crosses two joints (shoulder and elbow) and helps with bending your elbow, rotating your forearm and aids in lifting the arm at the shoulder.  The biceps attaches to the shoulder blade (scapula) in the shoulder and one of the forearm bones (radius) in the elbow via tendons.  Tendons consist of thick fibrous connective tissue and can withstand large amounts of tension.

When the biceps tendon ruptures at the elbow, it is a result of a traumatic injury such as forceful stretching of the muscle.  When it is torn, elbow rotation (moving from palm down to palm up) will be significantly limited.  Shoulder motion and bending of the elbow may not be a major issue.  You may experience a loud pop and/or pain.  Pain is usually present immediately after injury but commonly subsides after a few days.  Swelling and bruising may be present after the initial injury.  You may see a large bulge at the upper end of the arm from the biceps muscle “rolling up” the arm.

The biceps tendon at the elbow cannot heal on its own and may require surgical repair.  Nonsurgical management may be appropriate if the patient is elderly or has too many health risks for surgery.  Surgical management, if performed, will need to be done within the first few weeks after injury before the tear becomes scarred down.  The surgery is done to re-attach the biceps tendon to the radius with a metal implant.

After a biceps tendon repair, performing rehabilitative exercises may gradually return full flexibility and function to your elbow.  Building strength in your forearm and arm muscles to support the repaired muscle is the primary goal of rehabilitation.  It is important not to return to full activity too soon to prevent reinjury.