Torn Biceps

By Lily Condy, MOTR/L, CLT

What is a Torn Bicep?

The biceps muscle is located at the front portion of the upper arm. It attaches near the elbow in the forearm and has two heads that attach near the shoulder. If you are experiencing pain in the upper portion of the arm you could have a torn bicep.

Image of Bicep

Anatomy of the Bicep

The biceps muscle functions to rotate the forearm from palm down to palm up and help bend the elbow. Following a sudden injury or repetitive strain, it’s possible to tear or fully rupture your biceps muscle tendon partially. These torn biceps can occur near the elbow (distally) or near the shoulder (proximally).

Proximal Biceps Tear

Injury is more common to the proximal portion of the biceps than to the distal portion. It often occurs following a fall onto an outstretched arm or from lifting a heavy object. Proximal biceps tears are frequently caused by overuse and frayed tendons, both of which happen naturally with age and over time.

The rotator cuff or labrum may also include a proximal biceps tear. There are two heads to the proximal biceps, the long head, and the short head. Injuries nearly always occur to the biceps’ long head, meaning that the short head is still intact. This results in many patients having almost full use of their biceps and requiring no intervention.

The symptoms of a proximal biceps tear may include:

  • Sudden, sharp pain in the upper arm near the shoulder
  • Bruising in the upper arm
  • An audible snap or pop
  • Cramping throughout the biceps muscle
  • Weakness with elbow flexion or forearm supination (palm up)
  • A “Popeye” deformity, caused by the tendon balling up in the arm from rupture

Typically, a proximal torn biceps muscle treatment is with ice, rest, anti-inflammatory medications, and therapy. Rarely is the surgical intervention necessary for these types of injuries.

Distal Biceps Tear

Injuries to the distal biceps tendon can be either partial or complete ruptures. They often occur in the dominant arm of middle-aged adults. Unanticipated loading of the tendon is commonly the injury mechanism, causing the biceps muscle to contract, but the elbow is rapidly straightened. This may happen when a heavy object unexpectedly falls and attempts to be caught or when a person falls and grabs overhead for support. Once torn, the biceps tendon will not grow back to the bone and must be surgically repaired.

Functionally, distal biceps ruptures will cause weakness in both forearm supination (rotating the palm upward) and elbow flexion. This type of tear generally affects supination more than elbow flexion. Other arm muscles can compensate for a distal biceps rupture, but certain activities, such as using a screwdriver or lifting heavy objects, can be difficult.

JOI Rehab image of the anterior shoulder muscles and anatomy with labels for supraspinatus, long head of Biceps, subscapularis and subacromial bursae

Shoulder muscles and bicep tendon

The symptoms of a distal biceps tear may include:

  • Sudden pain at the elbow that subsides quickly
  • A loud pop during lifting
  • Bruising in the front part of the arm near the elbow
  • Difficulty or weakness rotating the palm upward
  • Difficulty or weakness with bending the elbow
  • A bulge in the front part of the arm near the elbow from the muscle retracting.
  • A gap in the elbow from where the tendon can no longer attach

A doctor will diagnose the injury with clinical examination and possibly with an MRI. Surgical repair is nearly always indicated. Older, less active individuals may choose not to undergo surgery, as the rehabilitation time is lengthy.

What JOI has to offer?

JOI has a dedicated team of physicians that are dedicated to your orthopedic treatment. If you are experiencing any of the symptoms above and would like to see a physician regarding this, JOI offers five different MD locations, and they are located throughout the northeast Florida area.

Related Links: Biceps Tendonitis, and Bicep Injuries.

Furthermore, JOI also offers physical therapy in numerous areas in northeast Florida.  To schedule for physical therapy, please call 904-858-7045.

For more information or to make an appointment, please call 904-JOI-2000.

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