The biceps muscle is located at the front of the upper arm and is attached to the elbow and the shoulder with tendons. Tears to the tendons can be either partial which is more common or complete. A complete tear will split the tendon into two pieces meaning that the entire muscle is detached from the bone and pulled toward the shoulder. Injury can occur when the elbow is forced straight against resistance for example lifting a heavy box with straight arms.
There is often a pop at the elbow, with severe pain, swelling and bruising around the elbow and upper arm. There may be a bulge in the upper part of the arm (the biceps muscle) and a gap in the front of the elbow created by the absence of the tendon. Weakness in bending of the elbow and in rotating the palm face down or face up.
Non-surgical: May be considered for elderly or inactive patients or for those with medical problems making them unsuitable candidates for surgery. This decision is important as once the tendon and muscle begin to scar and shorten surgical repair may not be possible.
Surgical: Surgery to repair the tendon should be performed in the first 2-3 weeks following injury to get the best results and ensure restoration of arm function. The tendon can be reattached to the bone with sutures (stitches) or small metal implants.
Following surgery the arm will be immobilised in a splint or cast. Once physical therapy has begun a brace may be used to protect certain movements while healing takes place. It takes approximately two to three months for the tendon to fully heal and it is important to protect the repair by restricting certain activities. The rehabilitation therapy is important to help regain strength and range of motion in the joint.