Biceps Injuries

Biceps injuries

The biceps is the muscle at the front of your upper arm which you use to bend your elbow and twist your forearm. There are three tendons that attach your biceps to the bone:

The short head tendon attaches the biceps to your coracoid process, which is the bumpy part at the front of your shoulder blade.
The long head tendon attaches the biceps to the top of your shoulder socket (glenoid).

A third tendon attaches the biceps to the radius (one of the bones in your forearm).

Any of these tendons can tear or become detached from the bones.

What causes biceps injuries?

Damage to your biceps tendons is normally due to injury – for example, by falling onto your arm or heavy lifting. It can sometimes become injured as a result of overuse – this happens naturally as we age but is made worse by repetitive movements such as tennis or weightlifting.

There are several types of biceps injuries:

A proximal biceps tendon tear occurs when one of the tendons attaching the biceps to the shoulder tears. It is more likely to be the long head tendon than the short head tendon that tears. Tendons are made of strong, smooth fibres which can tear apart and become frayed due to excess stress, repetitive or prolonged use. This triggers an inflammatory response and can lead to tendonitis and pain.
A biceps tendon tear can occur at the elbow if the elbow is pushed hard against a heavy weight. These types of tears are relatively rare – five or fewer in every 100,000 people – and are more common in men than in women. Distal biceps tendonitis is inflammation in the tendon near the elbow, which is exacerbated by repetitive movements.
Tendonitis is inflammation of the biceps tendon due to wear and tear. It is typically exacerbated by repetitive movements, leading to microtears. It often occurs alongside a rotator cuff tear or arthritis.

What are the symptoms of biceps injuries?

If you tear a biceps tendon you may experience:

Pain, which can be severe at first
A tearing sensation or popping sound at the time of the injury
Swelling and bruising around the injury site
Weakness in your arm and difficulty turning your palm
A bulge in your upper arm or gap in front of your elbow as the biceps is not being held in place

How are biceps injuries diagnosed?

Your consultant will take a history of how the injury occurred and will examine you to test your range of motion and strength. They will assess your arm for signs of swelling and bruising, or bulges. You may need an X-ray to rule out any fractures or an MRI to establish the extent of the tear.

How are biceps injuries treated?

Rest is important for a biceps injury and you should use your arm as little as possible, avoiding any activity that causes pain. Anti-inflammatories can reduce inflammation and a physiotherapist can recommend exercises to help you to regain strength and movement in your arm and alleviate pain.

If more than half of the tendon is torn or if less invasive methods do not restore full movement to your arm you may require surgery to reattach the tendon to the bone.

Dr. Prasad Bhagunde

MS Ortho D Ortho DNB

Senior Orthopaedic Consultant and Sports Medicine Surgeon