If you’ve ever injured your shoulder or upper arm, you know how painful and even debilitating those types of injuries can be.
If you have injured or are experiencing pain in or around your bicep, there are several possible issues that you could be dealing with, including a biceps tear.
If you suspect that you have a torn bicep muscle, biceps tendon rupture, or any related issue, contact your orthopaedic surgeon as soon as possible.
For some background, the biceps are a muscle located at the front of the upper arm, connected to the scapula bone in the shoulder by two tendons and the radius bone in the elbow by one tendon.
This muscle and associated tendons control the shoulder and the elbow and how the two joints interact with each other.
You may have heard of it referred to as the “Popeye muscle” after the beloved cartoon character with impressive biceps.
What is a bicep tear?
A bicep tear or rupture occurs when one of the tendons connecting the bicep to the bone becomes frayed or damaged, and eventually tears.
Torn biceps usually happen either as a result of constant and consistent overuse or a serious and traumatic injury.
Bicep tears occur at the shoulder and the elbow, and the tears can be complete or partial; a complete tear happens when the tendon has completely separated from the bone while in a partial tear some of the tendon is still connected to the bone.
The two types of shoulder biceps tears
There are two different types of biceps tears, shoulder or proximal biceps tears and distal biceps tendon tears.
Proximal biceps tears occur when one of the two tendons that connects the biceps muscle to the shoulder – either the “long head” tendon that attaches the bicep to the top of the scapula or the “short head” that attaches the biceps muscle to the front of the shoulder socket (on the coracoid bone) is fully or partially torn (note that most biceps tendon tears occur in the long head tendon).
Tears of the short head of biceps tendon are extremely uncommon.
If a tear of the proximal biceps tendon occurs there is a risk that the rotator cuff tendons are possibly damaged as well.
A distal biceps tendon tear happens to the single tendon – the “distal tendon” that connects the biceps to the elbow; these types of tears are relatively common, typically are caused by an injury or trying to lift an overly heavy object and occur in people generally over the age of 40 years.
Distal biceps tendon tears tend to be complete tears where the muscle and tendon is fully separated from the bone.
What causes a bicep tear?
Both types of biceps tears can happen when the shoulder or elbow joints (or both) are twisted in an awkward and unnatural way, or if you fall down with your arm outstretched, trying to catch yourself or break the fall.
Lifting heavy objects or moving large pieces of furniture is often the cause of biceps tears at the elbow as well.
Some of the risk factors for bicep tears or biceps tendon ruptures include age, being a smoker, shoulder overuse through sports (baseball, tennis, AFL) or workplace activities (construction, carpentry) that require repetitive overhead or overhand shoulder motion, regular heavy overhead lifting activities (weightlifting or highly physical jobs), and regular use of corticosteroid medications.
What are the signs and symptoms of a bicep tear?
If you experience sudden, severe pain in the upper region of your arm or shoulder, or near the elbow, then you may have a bicep tendon tear and you may or not hear or feel a popping sensation when you tear a tendon.
You may also experience sharp pain in your shoulder or elbow and a feeling of weakness at those joints, and pain may radiate down anteriorly to the muscle belly.
Other symptoms of a torn bicep include bruising on your upper arm or forearm. There may also be a shift in the shape or contour of the bicep muscle at the front of your arm.
This is known as a “Popeye” deformity due to the bunching up of the muscle in the lower part of the upper arm.
Lastly, you may also have difficult turning rotating your arm into different positions; e.g. from a palm up to palm position.
Partial bicep tear vs complete biceps tears
A partial bicep tear occurs when the tendon isn’t fully detached from the bone, and will more than likely be the aforementioned proximal biceps tear or shoulder biceps tear as opposed to a distal biceps tear.
They can be more complicated to diagnose since these contours of the muscle usually do not change or “pop” like they do in a completely ruptured bicep, and may occur from a strain over time as opposed to an acute injury.
On the other hand, a complete biceps tear is when the tendon completely detaches from the bone and the muscle retracts; these are more common at the elbow joint but they can occur at the shoulder as well.
How is a bicep tear diagnosed?
Imaging tests like X-rays and magnetic resonance imaging (MRIs) along with a battery of physical tests are used to diagnose biceps tears and rule out other shoulder injuries or issues.
The problem is usually fairly apparent with complete ruptures because of the “Popeye” appearance of the bicep muscle; however partial tears may be less obvious and your surgeon will ask you to move and rotate your arm in a variety of ways to determine the source of your pain and if you have a partially torn bicep or another similar issue.
What shoulder and arm issues are similar to bicep tears?
Bicep tendonitis can feel similar to a bicep tendon rupture or a torn bicep, and partial tears are often treated in a similar fashion.
Bicep tendonitis is an inflammation of the long head tendon or the main tendon that attaches the top of the biceps muscle to the shoulder.
It’s often caused by overuse or excessive strain from repetitive overhead lifting or overhand throwing motions common in certain sports.
Rotator cuff injuries and shoulder impingement are other related similar injuries, and some of the symptoms may present in the same way.
Your doctor will use the aforementioned diagnostic tests to determine exactly what your issue is and then work with you on a treatment plan for it.
Non-surgical treatments for biceps tears
Surgery may be needed to repair a torn bicep tendon, particularly if it is a complete tear and the pain is affecting your ability to perform everyday tasks.
However, in some cases people with torn tendons can still function normally with physiotherapy and close monitoring by an orthopaedic surgeon.
You should be aware that partial shoulder biceps tears are more likely to respond to nonsurgical options, while full thickness biceps tears at either the shoulder or elbow joint are more likely to require surgical intervention.
Ice packs, non-steroidal or anti-inflammatory medication, and resting the affected arm will also be recommended.
Surgical treatments for biceps tears
If you have suffered a torn bicep and it’s not responding to nonsurgical treatment, then surgery is the next choice, especially if you are still in significant pain, suffering from weakness at the shoulder or elbow joint, or if the shape and contour of your bicep muscle is still raised or appears to be a “Popeye muscle”.
Surgery for a torn bicep can often help you regain nearly all of your normal arm strength and function.
Note that if you do choose to have surgery on an elbow or shoulder biceps tear, you’ll need to work with a physiotherapist on your arm’s flexibility and strength for at least several months post-surgery.
Biceps tear surgery recovery time
You will likely need to spend some time with your affected arm in a sling and will want to plan ahead prior to your surgery for some immobility.
If you can, set up things up in advance (e.g. placing commonly used items in places where you can reach without used the impaired arm), make some meals ahead of time, and ideally have a friend or family member around to help you in the immediate aftermath.
The immediate post-surgery days will be fairly similar to any other type of surgery, with antibiotics and painkillers being prescribed.
You should be able to go home fairly quickly or perhaps even the same day as your surgery, but will need a fair amount of help as previously described, since you won’t be able to use your affected shoulder.
Your arm will be in a sling when you leave the hospital and probably for some time afterwards, but you should be fairly independent not too long after a successful biceps tendon repair surgery.
Rehabbing a bicep tear
Physiotherapy is always recommended for any type of biceps tear or biceps tendonitis, with the goal of strengthening the arm and restoring its functionality and flexibility.
This may be required for a few months or longer, depending on the severity of the tear, your arm’s condition prior to the tear, and a number of other factors. Your orthopaedic surgeon will work with you on a treatment plan.
How to prevent a bicep tear
There are a number of preventative measures that you can take to avoid experiencing a rupture or tear in your bicep tendons, including working out to maintain strength and flexibility in your shoulders, elbows, and forearms, especially as you get older.
Some physical activities should also be avoided as you age since the tendons weaken and are more likely to fray in older individuals.
Repetitive overhead lifting, overhand throwing, extremely forceful pushing or pulling activities like rowing, or simply lifting heavy objects (weightlifting or even simple household tasks). You should also use special care when lowering heavy objects to the ground.
And of course, being a nonsmoker and not using steroids will help prevent bicep tears along with a number of other health conditions.
If you think you may have torn or ruptured your bicep or have any other pain or issues in your joints, the next step should be to contact your orthopaedic surgeon to diagnose the problem and determine the proper course of treatment.
The most common symptom of a bicep tear or strain is a sudden burst of pain in the upper arm near the shoulder. You could also hear a “popping” sound as the tendon tears. Other signs that you may have torn a bicep tendon can include: Weakness in the shoulder.What happens when the bicep tears at the shoulder? ›
If you tear the biceps tendon at the shoulder, you may lose some strength in your arm and have pain when you forcefully turn your arm from palm down to palm up. Most people can still function at a high level with a biceps tendon tear around the shoulder and only need simple treatments to relieve symptoms.How painful is a bicep tear? ›
Sharp, sudden pain
Complete tears split the biceps tendon into two separate pieces. No matter where your biceps tear is, sharp, sudden pain is a common symptom. Both partial and complete tears are painful and can significantly compromise your arm's mobility.
If your biceps tendon rupture was caused by an accident and you heard a pop, icing several times a day can keep down swelling. Nonsteroidal anti-inflammatory medications can ease pain and swelling, too. Rest, placing your arm in a sling, and physical therapy can restore movement and strength.Can a torn bicep cause shoulder pain? ›
Most problems of the long head of the biceps cause pain over the front of the shoulder; often people feel a snapping or clicking sensation. In addition, biceps tendon problems are commonly associated with rotator cuff problems, so in many cases, both of these problems need to be treated together.Can a torn bicep tendon heal without surgery? ›
Most biceps tendon tears can be treated nonsurgically, but we can perform minimally invasive surgery called arthroscopy to repair it if necessary.Can a bicep tendon tear heal itself? ›
Will a bicep tendon heal itself? Once a bicep is torn, it unfortunately will not reattach itself to the bone and heal on its own. There are, however, a variety of treatment options available depending on the severity of your injury and whether it was a partial or complete tear.Will an MRI show a bicep tear? ›
Conclusions: Magnetic resonance imaging is an effective tool for diagnosing distal biceps tendon ruptures. Although MRI is extremely sensitive in diagnosing complete tears, it is substantially less sensitive in diagnosing partial tears.Is bicep tear permanent? ›
Unfortunately, if a tear has occurred at the elbow the biceps tendon will not grow back to the bone and heal itself regardless of what therapies you try. Although some movement may be possible due to the function of the other muscles in the arm, the full capabilities and strength of the arm will not be possible.How do you test for bicep injury? ›
Speed's Test for Biceps Tendonitis - Ask Doctor Jo - YouTube
It takes about 3 to 4 months for your biceps muscle to heal. You may be able to do easier daily activities in 2 to 3 weeks, as long as you don't use your injured arm.How long can you wait to repair a torn bicep? ›
Surgery to repair the tendon should be performed during the first 2 to 3 weeks after injury. After this time, the tendon and biceps muscle begin to scar and shorten, and it may not be possible to restore arm function with surgery.What happens if a torn tendon is not repaired? ›
If left untreated, eventually it can result in other foot and leg problems, such as inflammation and pain in the ligaments in the soles of your foot (plantar faciitis), tendinitis in other parts of your foot, shin splints, pain in your ankles, knees and hips and, in severe cases, arthritis in your foot.Should you wear a sling for a bicep tear? ›
Apply ice packs several times a day to reduce swelling. Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, or naproxen for relief of pain and inflammation. Rest the affect arm: Don't lift anything heavy or engage in activities that require you to reach overhead. Wear a sling if necessary.Can I live with a torn bicep tendon? ›
The tendon itself can either tear partially or entirely. Most people will be able to continue living their lives without ever having to get surgery. A biceps tendon tear will cause you to lose some strength and mobility in your shoulder, but not enough to make a difference in your daily activities.Can a torn bicep tendon cause neck pain? ›
The main symptoms of biceps tendonitis are pain in front of the shoulder and tenderness to the touch. In addition: The pain generally gets worse when performing any overhead or lifting activities. In some patients, pain will radiate down the elbow or towards the neck.Where is bicep tendon pain? ›
Bicep tendonitis is an inflammation of the tendons that connect the biceps muscle, at the front of your arm, to the shoulder and the elbow. A repetitive motion injury, bicep tendonitis often results from overuse caused by a repeated overhead motion.How successful is bicep tendon surgery? ›
Biceps tenodesis is successful more than 70% of the time.Can I lift weights with a torn bicep tendon? ›
You will likely start moving the arm soon to prevent stiffness, but you will not be allowed to lift anything for a number of months. If you try to do too much you will re-tear the biceps tendon.How do I know if I tore a tendon? ›
- A snap or pop you hear or feel.
- Severe pain.
- Rapid or immediate bruising.
- Marked weakness.
- Inability to use the affected arm or leg.
- Inability to move the area involved.
- Inability to bear weight.
- Deformity of the area.
Ultrasound can reliably diagnose complete rupture, subluxation, or dislocation of the biceps tendon. It is not reliable for detecting intraarticular partial-thickness tears.What does a torn bicep tendon look like on MRI? ›
MRI findings of an acute complete distal biceps tendon rupture are best seen on fluid sensitive series and include discontinuity of the tendon at the insertion site with a fluid-signal filled gap, increased intratendinous signal intensity, and increased signal intensity in the biceps muscle belly and surrounding soft ...Can a bicep tear heal on its own? ›
Once a bicep is torn, it unfortunately will not reattach itself to the bone and heal on its own. There are, however, a variety of treatment options available depending on the severity of your injury and whether it was a partial or complete tear.How do you tell the difference between a pulled muscle and a torn muscle? ›
Symptoms of a strain include muscle spasms, weakness, cramping, immobility, pain, bruising and swelling. It can take a few weeks for symptoms of a mild-to-moderate strain to ease, he explained. A tear is the ripping of tissue in ligaments, muscles or tendons.How do you test for bicep injury? ›
Speed's Test for Biceps Tendonitis - Ask Doctor Jo - YouTubeCan a torn rotator cuff cause a bicep tear? ›
When the rotator cuff is torn, the ball of the humerus is free to move too far up and forward in the shoulder socket and can impact the biceps tendon. The damage may begin to weaken the biceps tendon and cause it to eventually rupture.Is bicep tear permanent? ›
Unfortunately, if a tear has occurred at the elbow the biceps tendon will not grow back to the bone and heal itself regardless of what therapies you try. Although some movement may be possible due to the function of the other muscles in the arm, the full capabilities and strength of the arm will not be possible.What happens when a bicep tendon tears? ›
A distal biceps tendon tear can cause the muscle to ball up near the shoulder. Bruising at the elbow is also common. There is often a pop at the elbow when the tendon ruptures. Pain is severe at first, but may subside after a week or two.What happens if a torn tendon is not repaired? ›
If left untreated, eventually it can result in other foot and leg problems, such as inflammation and pain in the ligaments in the soles of your foot (plantar faciitis), tendinitis in other parts of your foot, shin splints, pain in your ankles, knees and hips and, in severe cases, arthritis in your foot.What does a tendon tear feel like? ›
What are the symptoms of a ruptured tendon? Severe pain is the first and most evident symptom. You may also hear a snapping or popping sound at the time of injury. Another common, immediate sign of a tendon rupture is rapid bruising at the site of injury.
Our doctors often use ultrasound to diagnose muscle, tendon, and ligament injuries because the imaging test can produce clearer picture of soft tissues. Doctors use MRI scan to examine the ligaments to determine the extent of a knee injury.
There may be a snapping sensation and immediate weakness in your upper arm. Tears that develop slowly due to overuse may also cause pain and arm weakness. You may have pain in the shoulder when you lift your arm, or pain that moves down your arm.Does shoulder MRI show bicep tendon? ›
What are some common uses of the MRI procedure? MRI is an excellent choice for examining the shoulder joint. MRI gives clear views of rotator cuff tears, injuries to the biceps tendon and damage to the glenoid labrum, the soft fibrous tissue rim that helps stabilize the joint.How long does a torn bicep take to heal? ›
It takes about 3 to 4 months for your biceps muscle to heal. You may be able to do easier daily activities in 2 to 3 weeks, as long as you don't use your injured arm. Most people who work at a desk job can return to work in 1 to 2 weeks.