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Biceps Tendon Rupture

To understand a Biceps Tendon Tear, we must first understand the anatomy of biceps. Biceps are muscles present in the front of the upper arm and stretches from shoulder to elbow. Tendons are tough connective tissues that help the bicep muscles attach to the bones at the shoulder joint and the elbow joint. Each biceps muscle has two heads (hence called biceps) which begin at the shoulder as two separate pieces and becomes a single piece midway down the upper arm. One of the tendons is called the long head, it attaches to the upper arm bone. The other tendon is the short head which attaches the biceps to a bony bump on the shoulder blade called the caracoid process.

Biceps Tendon Rupture

A Biceps Tendon Tear or Injury is the rupture to these tendons. By this rupture, the muscle separates from the bones. The rupture can occur in the shoulder tendons or elbow tendons however it is more common in the shoulder tendons. When the rupture occurs in the tendons at the shoulder it is called Proximal biceps tendon rupture and when it occurs in the tendons at the elbow it is called Distal biceps tendon rupture.

The biceps muscle is used in performing a range of activities like lifting, rotating, bending the arm and reaching over the head. Hence a rupture to the biceps tendon affects these primary functions. A bicep tendon rupture can either be partial or complete. In partial, it does not completely tear the tendon whereas in complete the tendons are cut into two and separates from the bones.

Bicep tendonitis / tendinitis / tendinopathy / tendinosis / tenosynovitis/ Shoulder Biceps Rupture/ Ruptured Biceps at the Shoulder are all common terms that describes a tear or injury to shoulder's bicep tendons.

Signs and Symptoms of a Biceps Tendon Injury

    • Pain at the front of the shoulder which worsens on performing activities like overhead lifting
    • Pain that radiates down the arm
    • An intermittent snapping or popping sound in the shoulder when you move it
    • Weakness in the shoulder and arm
    • Difficulty rotating your upper arm
    • Bulge above the elbow
    • Bruising to the upper arm

Causes of Bicep Tendonitis

Biceps tendon tears are common in bodybuilders and athletes who perform weight lifting and other repetitive activities. These injuries are more common in men than women. It is also a common sports injury for swimming, tennis, baseball, basketball etc. Other than this, it can occur in individuals due to trauma like accidents, due to old age.

Common risk factors that increases the chances of getting a Biceps Tendon Tear are:

    • Age – It is common in elderly people due to wear and tear of the tendons
    • Certain occupations – Like construction workers, porters who lift heavy
    • Smoking
    • Corticosteroid medications
    • History of shoulder problem

Diagnosing a Biceps Tendon Tear

Your Orthopaedic Doctor/Shoulder Specialist will diagnose a Biceps Tendon Tear with one or more of the following methods:

    • Studying your medical history
    • Physical Examination
    • X-rays
    • Ultrasonography
    • MRI Scans

Treatment of Biceps Tendinopathy

Depending on the severity of the condition of your Biceps Tendon Injury, your Shoulder doctor will recommend the following course of treatment:

    • Rest
    • Icing
    • Medications (Non-steroidal)
    • Medications (Steroids) – For cases where non-steroidal drugs does not improve the condition and the situation demands
    • Physical Therapy
    • Surgery

Surgery for a long head of the biceps tendon tear is rarely needed. However, for some patients (particularly athletes) the conservative non-surgical treatment options does not help and those who  need complete recovery of the strength, surgery is recommended. Several new procedures like Biceps Tenodesis, Acriomioplasty and Direct Tenodesis have been developed which uses keyhole (arthroscopic) techniques to perform the correction.

In case a surgery is required, it is always better to perform it as soon as possible because otherwise the tendon gets retracted up the arm and gets stuck which becomes difficult to retrieve with small incisions.

Rehabilitation post-surgery

Soon after the surgery, your doctor will ask you to wear a sling. You will be asked not to perform certain activities for a recommended period of time. Post which you will be put on a customized therapeutic exercise starting with slow exercises and leading to active strengthening exercises which will help gradually strengthen your muscles.

For questions related to diagnosis or treatment options for a Bicep Tendon Injury, you can send your questions to Dr Ayyappan Nair, Shoulder Specialist in Bangalore. Send your message here -

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