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What is a Distal Biceps Tendon Rupture?

The biceps muscle located in the front of the upper arm allows you to bend the elbow and rotate the arm. Biceps tendons attach the biceps muscle to the bones of the shoulder and the elbow.

Biceps tear can be complete or partial. Although two tendons attach the biceps muscle to the bones at the shoulder, only one tendon attaches it to the elbow. This is known as the distal biceps tendon. Tears of the distal biceps tendon are usually complete and the muscle is separated from the bone.


Causes of Distal Biceps Tendon Rupture

Biceps tendon tear can be caused by injury such as falling with your arm outstretched or during the act of lifting heavy objects. Overuse of the biceps can cause the distal tendon to fray and eventually tear.


Symptoms of Distal Biceps Tendon Ruptures

The most common symptom is a sudden, severe pain in the elbow. At times, you may hear a “pop”. Other symptoms include swelling, visible bruising, weakness in the elbow, and trouble turning your palm up or palm down. A bulge referred to as a “Popeye Muscle,” may also appear in your arm, because the tendon is no longer holding the biceps muscle in place.


Diagnosis of Distal Bicep Tendon Ruptures

Biceps tendon tear is usually diagnosed based on your symptoms, medical history, and a physical examination. During the physical examination, your doctor will look for a gap in the front of the elbow. Your doctor will diagnose a partial tear by asking you to bend your arm and tighten the biceps muscle. You may have pain if there is a partial tear. X-rays may be taken to rule out other conditions causing elbow pain. Using an MRI scan, your doctor can know whether the tear is partial or complete.


Treatment Options for Distal Biceps Tendon Ruptures

Your surgeon may opt for several surgical procedures for distal bicep tendon tear where the distal biceps tendon is reattached to the forearm bone. The procedure may require one or two incisions. During the procedure, the tendon is attached with stitches through holes drilled inside the bone or small metal implants may be used to attach the tendon to the bone.


After Your Surgery

After the repair is complete, a hinged elbow brace will be applied with your elbow bent at 90 degrees. The brace will be removed after 6 weeks and it may take up to 6 months -1 year to regain full strength.


Your Rehab

Following surgical repair, you will need to do flexibility and strengthening exercises to improve the range of motion in your elbow.


Risks and Complications of Distal Biceps Tendon Repair 

Complications are rare and may include:

  • Numbness and weakness in the forearm

  • Formation of new bone

  • Limited movement

  • Recurrence of tearing

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