Bicep’s Tendon Tear. Is This a big deal?


Most people have heard of Achilles tendon tears and recognize that not only can this be a season ending injury for an athlete but not uncommonly, career ending as well.


Surgical repair and rehabilitation are both better than in the past, however not all athletes recover full high-level function.


The post recovery demands for “civilians” are usually less, but still the results may not be always optimal.


Many are surprised to learn that biceps tendon tears are far more common and usually recovery much quicker and more certain.


Just about everybody knows that the biceps flexes the upper extremity at the elbow. Fewer know that while the biceps tendon has a single attachment to the forearm just below the elbow, it has two attachments in the shoulder, the long head and a short head. Thus, the name “biceps”.

The long head is a long, thin tendon, far more likely to rupture than thick short head. Once long head ruptures the whole bicep slumps down a bit toward the elbow and one has a “Popeye” appearing upper arm. But for most people function is surprisingly good. They have well over half of their flexion strength remaining and given the bicep muscle is very responsive to strengthening exercises, often those with a rupture of the long head of the bicep following relatively short strength training are stronger than they were prior to the injury.


Ruptures of the single distal attachment are much less common and often unrecognized. These injuries are often assumed to be “a muscle’s strain” because still functioning is the injured stronger flexor of the elbow, the more powerful brachialis. It’s commonly assumed that the bicep is intact because elbow flexion remains relatively strong. There is a relatively short window for repair of the distal bicep tendon so if full restoration of flexion strength is needed, the injury must be recognized and treated early.


An orthopedic surgeon can help sort all this out. If one gets shoulder pain with a funny looking upper arm, or pain in the upper arm around the elbow, best to be evaluated by experts, the doctors at Central Montgomery Orthopedics.

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