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Bicep Tendon Rupture


Updated September 04, 2006

The bicep brachii muscle is one of the major flexors of the elbow joint. In other words, this muscle allows us to bend our elbow to lift objects and perform daily tasks. The bicep brachii muscle divides into two muscular portions slightly above the mid portion of the arm, and thus its proximal bony attachment is formed by two separate tendons, the long head and short head bicep tendons. Each tendon has a separate insertion site. The long head bicep tendon originates from the supraglenoid tubercle of the scapula, and the short head tendon from the coracoid process of the scapula. The distal tendon of the bicep brachii muscle inserts on the radius bone of the forearm. Rupture of the proximal bicep tendon accounts for around 95% of all bicep tendon ruptures with almost always exclusive involvement of the long head muscle tendon.

Rupture of the bicep tendon can be caused by several different mechanisms. Acute tears are caused by excessive loading or rapid stressing of the elbow joint such as during weightlifting activities. Partial tears can be the result of chronic impingement and fraying of the tendon under the acromion of the scapula and can also occur along with rotator cuff injury.

Symptoms of biceps tendon tears include sudden sharp pain felt in the upper arm. There is also tenderness to palpation at the shoulder joint. An audible snap can occasionally be appreciated. A soft mass may be felt in the upper arm, and is a result of the muscle belly rolling up on itself.

Diagnosis of this disorder includes physical examination by your physician as well as imaging studies if needed. There are several specialized tests that can evaluate and assist in making the diagnosis of a bicep tendon tear.

Conservative therapy includes limiting activity of the involved extremity, non steroidal anti-inflammatory medications, as well as a comprehensive physical therapy program. Your physician will make the decision as to whether surgical repair is necessary.

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