Biceps tear occurs when the muscles in the shoulder or elbow pull apart causing the inability of the forearm to rotate, pull or bend the elbow. A bicep tear can either be partial whereby the tendon is damaged, or completely detached away from the bone.
The bicep is the muscle located in the front upper arm and has two tendons that connect it to the bones of the elbow and shoulder. The tendons are connective tissues that attach muscles to the bones. There are three types of tendons that connect the bicep to the bone of the shoulder and elbow. These are:
- The tendon which connects the bicep to the radius of the bone in the elbow
- The long head tendon which connects the bicep to the top shoulder socket
- The short head tendon that connects the bicep to the bump at the shoulder blade
Types of Biceps Tears
There are three ways in which a bicep can tear as a result of the tendon injury. These are:
Tendonitis of the shoulder
Tendonitis of the bicep occurs as a result of tedious motion and usual wear and tear together with conditions such as impingement, dislocation, and arthritis of the shoulder.
Proximal bicep tear at the shoulder
Proximal bicep tear affects one part of the tendon near the shoulder and can injure other parts of the shoulder when it’s not repaired. This occurs due to the tearing of the long head tendons that connect the bicep to the shoulder. This bicep tear is mostly caused by injury and fraying of the bone.
Distal bicep tendonitis and tear at the elbow
This is the soreness and tear in the bicep tendons that are near the elbow due to heavy weight bearing that pushes the elbow. The tear can pull the tendon completely from the bone, and the arm can lose its strength when repair is not done.
Symptoms of a Biceps Tear
The symptoms of a bicep tear are identified by the area and intensity of the tear. These include:
- A popping and twitching feeling when the injury occurs
- Soreness and bruising around the torn area
- Severe pain in the arm
- Weakness of the arm
- A bump on the arm
- Difficulty in motion
Causes of a Biceps Tear
The bicep can be torn at the shoulder or elbow as a result of:
- Overuse of the bicep muscle due to the repetitive motions especially in sports like swimming and weightlifting among others.
- Fraying or wear and tear as a result of aging
- Injury by a fall or heavy weight causing a tear at the elbow
- Corticosteroid medications and smoking can also cause a bicep tear
Diagnosis of a Biceps Tear
To diagnose a bicep tear, physical examination is done to identify the signs and symptoms of the tear and the reasons the arm is losing its function. An x-ray imaging test will also be done to check other conditions, and an ultrasound or MRI scan to check the extent of the injury of the muscles and tendons.
Treatment Options of a Biceps Tear
The treatment for bicep tear can be either surgical or non-surgical.
The surgical option is considered immediately after a complete bicep tear is diagnosed whereby the non-surgical options are unable to repair the damage. The surgery is done to reattach the torn tendon back to the bone and avoid scaring of the muscle and distal tendon (near the elbow).
The surgical procedures include:
Acromioplasty and direct tenodesis: During this procedure a small front portion of the acromion (bone formed at the scapula of the shoulder joint) is removed to create space between the humeral head and acromion. This is performed on younger individuals who have had a shoulder injury.
Bicep tenodesis repairs the tendon that does not regenerate due to injury. The damaged ends of the bicep tendon are fixed and sutured to the bone with screws.
The complete healing process including physical therapy can take roughly three months before the patient can regain the range of motion.
Non-surgical treatment options
When there is partial tearing of the tendon the non-surgical treatment options are considered. These include:
Physical therapy: A designed therapy to help regain the range of motion and strength is performed for a given period of time depending on the intensity of the tear. The exercises include arm rotation, bicep curls, and extension of the arm among others.
Physical therapy is done with the aim of relieving pain and enhancing the healing process.
Medication: Oral medications such as non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed to relieve pain and reduce the inflammation that occurs from the bicep tendon damage. Platelet rich plasma (PRP) can also be injected into the injured shoulder to aid the healing process.
Rest: To reduce the level of damage caused by the bicep tear, rest from any physical activities that cause the over use of the arm is recommended.
Possible Complications After Surgery
Just like any other surgical procedure, there may be risks involved. These include:
- Weakness of the arm
- Numbness in the operated area
- Reoccurrence of the tear
Biceps Tear Recovery
Identifying the cause of the bicep tear and the outcome after the treatment is important as it enables one to have an effective recovery. The healing process of a partial tear can take an average of six months while a complete tear can take nine months. All these depend on the health, age of the patient and intensity of the damage.
Our board-certified orthopedic surgeons at King’s have extensive knowledge of the full range of shoulder disorders and will help you find the ideal medical solution for your condition. You can get in touch by filling in the form below.
Bicep tears, also known as bicep ruptures, occur when the tendon that attaches the bicep muscle in your upper arm to your shoulder or elbow is torn or broken. The tendon may be partially torn or totally torn away from the bone depending on the extent of the rupture.
A sudden strain on your arm from a fall or accident can cause the arm muscle to become strained, which can lead to the bands that attach your tendon to the bone breaking. An underlying condition like tendinosis, which weakens your tendons, is another factor in most tears. You may also be more prone to a biceps rupture if you smoke or use performance-enhancing drugs like steroids since these activities tend to decrease blood supply to the tendon, making it weaker and less able to support weight.
Biceps ruptures generally occur abruptly and are frequently accompanied by a “pop” sound in the front of your shoulder that instantly weakens your upper arm. Your arm may protrude up toward your shoulder; this is often a biceps muscle that balled up once it was detached. Similarly, typical of biceps tears are swelling and bruising anywhere from the elbow to the shoulder.
Contingent on their severity, bicep tears can be categorized as follows: Grade 1 happens when the bicep muscles or tendons are stretched too far, but your agility and strength are unaffected. Grade 2, which results in a moderate loss of strength or movement due to tears in the biceps or tendons. Grade 3 is characterized by severe pain at the injury’s onset as ligaments or muscles fully rupture or detach from the bone. The joint is rendered inoperable by the full rupture and it usually requires surgery to fix.
Your doctor could advise rest, physical therapy, heat or ice, and taking painkillers like ibuprofen if the tear is only partial and not too serious. Surgery may be suggested if a significant rupture results in a deformity, such as a biceps muscle being more pronounced in the lower arm.
It is recommended to have surgery to repair the tendon within the first 2 to 3 weeks following injury. After this point, the biceps muscle and tendon start to shrink and scar and surgery may not be able to restore arm function.
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