What is a biceps tendon injury?
The biceps muscle is the large muscle in the front of your upper arm. It is attached by strong tendons to the inside of the shoulder joint and to the radius bone below the elbow. The tendon at the elbow can rupture under very strong contraction of the biceps muscle. This generally occurs in men over 35 years of age, with ‘strength’ athletes, body builders and heavy manual workers being more likely to suffer this condition.
What are the symptoms of biceps tendon injury?
The symptoms of a biceps tendon injury are pain, bruising and swelling at the front of the elbow. The biceps muscle may retract up the arm creating a prominent bump known as the ‘Popeye sign’, especially on contracting the muscle.
What does your doctor look for?
Your doctor will take your medical history and perform a physical examination that will include getting you to flex your arm demonstrating the strength of your bicep. Your doctor will feel for your biceps tendon just above the elbow joint to see if it’s present.
What investigations are needed?
Your doctor will usually be able to diagnose a biceps rupture during a physical examination. An ultrasound scan or an MRI scan may be required if the diagnosis is uncertain.
How is a biceps tendon injury treated?
If you are unable to take the time off work and you’re not dependent on having full strength of your elbow, you may elect non-surgical treatment (eg physiotherapy). However, a biceps tendon rupture can lead to weakness of the elbow and forearm and you may end up having trouble twisting a screwdriver, turning a key or lifting weights. However, non-operative treatment may be suitable for patients whose livelihood and interests do not require the full strength of their arm.
The other option for treatment is surgical repair of the tendon.
Biceps tendon injury surgery
If surgery is considered, it needs to be done as soon as possible (ie within three weeks of the injury) to make the surgery technically easier, allow a smaller scar and better tendon healing. If the surgery is delayed, the tendon may retract up the arm making the surgery longer and more difficult.
The tendon is located through an incision over the front of the elbow. It is thenmanipulated down to where it had torn off the radius bone andreattached. The tendon is fixed into place with a small metal button on the other side of the bone and supported with an interference screw.
After surgery, your arm will be in a sling for 6 weeks but youmay immediately start doing exercise to maintain your range of motion. No strengthening exercise should be performed until at least 3 months after the surgery.
Our specialists at Orthopaedic Clinics Gold Coast will discuss whether this procedure is suitable for you at your visit.
Overall, greater than 95% of patients who have the surgery are happy with the results. But complications can occur. Some complications related to this condition include infection (less than 1% chance), damage to the surrounding nerves or blood vessels (also less than 1% chance) and further rupture of the repaired tendon. Rarely, there may a reduction in the range of motion of the elbow.