A biceps tendon tear at the elbow, also referred to as a distal biceps rupture, is the result of damage to the tendon that attaches the biceps muscle to the forearm.
Tears in this tendon may be partial or complete, in which the tendon is severed into two pieces. Complete tears may make a pop sound at the time of injury, as the tendon tears away from the bone. Pain is often severe at first, but may subside after a few weeks.
Patients often experience swelling and bruising around the front of the elbow. The forearm loses strength and the elbow feels weak while bending. Some patients are unable to twist their arms from palm down to palm up.
Left untreated, a tear to this tendon can lead to significant and permanent weakness. This condition is most common in middle-aged adults and is usually seen in the dominant arm.
Causes of Biceps Tendon Tears
In most instances of this condition, some degree of weakness and degeneration, or tendonitis, is already present in the tendon, making it susceptible to injury.
Tears to the tendon occur suddenly, when the biceps muscle is contracted and the elbow is forced to straighten against resistance. This may happen when catching a heavy object falling from a shelf or when lifting an unexpectedly heavy weight.
Tendon tears also occur frequently during contact sports like football, soccer or hockey, or while weight training.
Biceps Tendon Tear Diagnosis
In many cases, a medical history and physical examination of the elbow are enough to diagnose this injury. During the exam, the doctor will feel around the elbow to check for a gap in the tendon. The doctor will also test the strength of the forearm by having the patient rotate the arm against resistance.
The injured arm will be compared to the uninjured arm to determine the extent of weakness. X-rays are not helpful in diagnosing this condition, but they may be ordered if the doctor suspects damage to the bones of the forearm or elbow. An MRI may also be ordered so that the doctor can see the full scope of the injury.
Treatment for Biceps Tendon Tear at the Elbow
Nonsurgical treatments are typically the doctor’s first choice for partial tears, unless extensive damage is identified. This is especially true for patients who are inactive or elderly, or for patients with medical issues that make surgery risky.
This nonsurgical approach may include nonsteroidal anti-inflammatory drugs (NSAIDs), a sling to rest the elbow or electronic nerve stimulation. These treatments also may be recommended for patients who have suffered an injury to their non-dominant arm.
For patients with complete tears, surgery is often advised. Most doctors prefer to perform surgery within the first two weeks after the injury. Any longer, and scar tissue can develop in the biceps tendon and muscle, making surgical repair much more difficult.
If you have suffered a significant injury to your elbow and you suspect a biceps tendon tear, contact our office immediately for a medical evaluation.