Distal Biceps Tendon Ruptures
The biceps muscle, located along the front of the arm, allows you to bend your elbow and rotate your forearm to turn the palm upward. Tendons attach the muscle to bones at the shoulder and the elbow. You can think of the tendon as a rope that attaches the muscle to the bone. If the rope is not connected, the muscle cannot perform its function.
The upper end of the biceps muscle transitions to two tendons that attach at two points on the shoulder. These are called the long and short heads of the proximal biceps tendon.
The lower end of the biceps muscle transitions to the distal biceps tendon, which attaches to a small bump on the radius (the forearm bone) called the radial tuberosity. Of all biceps injuries, only 3% occur at the distal insertion of the biceps muscle.
A distal biceps tendon rupture is a partial or complete tear of the tendon off the bone. Tendons do not have the capacity to heal on their own (back to the bone).. Thus, a distal biceps tendon rupture will not grow back, reattach, or heal to restore lost function.
A distal biceps tendon rupture is typically caused by an injury that involves a sudden force applied through the arm that rapidly extends the elbow from a flexed (bent) position. This can occur when lifting a heavy load.
A rupture of the distal biceps tendon is most common in men aged 30-50. Additional risk factors include weightlifting, corticosteroid medications, anabolic steroid use, and smoking. The majority of ruptures occur in the dominant arm.
- a popping or snapping sensation when the tendon tears away from the bone
- acute, severe pain in the front of the elbow
- bunching up of the biceps muscle near the elbow, leading to deformity
- a gap at the front of the elbow where the tendon has detached
- swelling and bruising
- weakness when bending and rotating the elbow
- cramping in the biceps muscle
Symptoms typically improve within a few weeks, and the elbow will still work because other muscles can take over the function of the biceps muscle. However, weakness will be obvious when flexing or rotating the forearm to turn the palm up. It may be particularly noticeable when trying to hold an object in this position for an extended period of time (early fatigue).
A tear or rupture may be partial or complete. A distal biceps tear usually requires surgery within two to three weeks after the injury to restore complete function and prevent too much tendon retraction/scarring.
Elbow surgeon, Dr. Daniel Kaplan, will ask how your injury occurred, discuss your symptoms, review your medical history, and conduct a physical examination. This will include performing specific range of motion testing and strength assessment comparing the injured arm with the uninjured arm. Imaging studies, including an ultrasound, x-rays, and an MRI, may confirm the diagnosis and distinguish between a complete and partial rupture.
Schedule an orthopedics consultation today.
If you’ve suffered a distal biceps tendon tear, schedule an orthopedic consultation today with Brooklyn’s leading elbow surgeon, Dr. Daniel Kaplan. Dr. Kaplan is an Assistant Professor of Orthopedic Surgery at NYU Langone Medical Center in Manhattan and Brooklyn. He is also the chief of sports medicine at Bellevue Hospital and the chief of sports medicine at the VA hospital in Manhattan He is a Sports Medicine and Shoulder fellowship-trained orthopedic surgeon specializing in diagnosing and treating shoulder conditions. You’re in expert hands.
At a Glance
Dr. Daniel Kaplan
- Fellowship-trained Sports Medicine and Shoulder Surgeon
- Expertise in Complex Shoulder Hip and Knee minimally-invasive reconstruction procedures
- Assistant Professor of Orthopedic Surgery at NYU
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