Biceps Tendon Tears
The biceps muscle has two tendons that attach the muscle to the shoulder(long and short head bicep tendons) and one tendon that attaches it at the elbow.
Biceps tendon tears can be either partial or complete.
- Partial tears. These tears do not completely sever the tendon.
- Complete tears. A complete detachment of the tendon from the bone.
The long head of the biceps tendon is the more likely tendon of the three attachments to be injured. This is because it is vulnerable as it travels through the shoulder joint to its attachment point within the shoulder socket. Fortunately, the biceps has two attachment heads at the shoulder, and the short head of the biceps rarely tears. When this second attachment remains intact, many people can still use their biceps even after a complete tear of the long head.
Tears of the biceps tendon at the elbow are less common. They are most often caused by a sudden injury, and tend to result in greater arm weakness than injuries to the biceps tendon at the shoulder, because there is only one attachment point. Once torn, the biceps tendon at the elbow will not attach back onto the bone and heal. Other arm muscles make it possible to bend the elbow fairly well without the biceps tendon. However, they cannot fulfill all the functions of the elbow, especially the motion of rotating the forearm from palm down to palm up. This motion is called supination. Sometimes there is only a partial tear to the tendon, which may heal to a certain extent and can be rehabilitated to a reasonable level of strength without surgery.
In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes when lifting a heavy object. Also If you fall hard on an outstretched arm or lift something too heavy, you can tear your biceps tendon. The lower bicep head tendon tear is a reasonably common injury in powerlifters(but not in the general population) using an under and overhand grip on the bar. It is the underhand grip arm the bicep usually tears on. Lifting with two overhand grips as in weightlifting is safer on the biceps but is seen as a weaker grip.
- Sudden, sharp pain in the upper arm while lifting with the arm
- Pain/Bruising of the bicep area near shoulder or elbow
- Weakness in the shoulder and the elbow
- Difficulty turning the arm palm up or palm down
- Because a torn tendon can no longer keep the biceps muscle tight, a bulge in the upper arm above the elbow (“Popeye Muscle”) may appear, with a dent closer to the shoulder.
I have seen many people with bicep tears lead normal lives, after a small bit of physio. The arm will be weaker but functional. If you require close to full recovery of strength in a torn bicep, surgery is required.