- Biceps distal tear
- Biceps proximal tear
- 727.62 Nontraumatic rupture of tendons of biceps (long head)
- 840.8 Sprains and strains of other specified sites of shoulder and upper arm
- M66.829 Spontaneous rupture of other tendons, unspecified upper arm
- S46.119A Strain of muscle, fascia and tendon of long head of biceps, unspecified arm, initial encounter
- Rupture of the biceps brachii tendon, either complete or partial
- Distal rupture will cause swelling, bruising, and a gap in front of elbow, created by absence of tendon
- Avulsion of the tendon from the radial tuberosity
- Proximal rupture will cause bulging, bruising, and gathering of the muscle (“Popeye” sign may indicate rupture)
- Avulsion of the long head of the biceps brachii from the superior rim of the anterior glenoid labrum
- History and clinical exam
- Diagnosis of proximal tear is often easily visible with observation due to bulge left by deformed muscle (“Popeye sign”)
- Diagnosis of distal tear
- Palpation of gap at elbow
- Manually testing supination strength compared with uninvolved side
- Sudden event trauma
- Partial tears can be harder to diagnose and may require manually testing bicep muscle for signs of pain with activation of muscle
- Occurs from a sudden high force, typically with weightlifting (i.e., bicep curls or activities with elbow flexion), eccentric force
- May arise from a repetitive type activity that leads to a gradual degeneration
- MRI can be used to show both partial and complete tendon tears
- History of repetitive motion, especially activities overhead
- Common in swimming, tennis, baseball, and with occupational activities involving repetitive or overhead activity due to microtrauma
- Smoking affects overall nutrition of tendon due to nicotine side effects
- Corticosteroid medications have been linked to decreased muscle and tendon strength
- Predominately individuals involved in repetitive activities in sports or work
- Long head tears are typically seen in the 4th decade of life
- Patient will describe an audible pop or snap associated with injury
- Sharp pain occurring suddenly in upper arm
- Ecchymosis, swelling, bulging of upper arm
- Pain and tenderness with palpation of shoulder and elbow
- Diminished strength of elbow flexion and supination
- Appearance of bulge (“Popeye muscle”) with indentation closer to shoulder for proximal tear
- Distal tear will result in bulge in upper part of arm due to recoiled, shortened tendon
- Distal tear will result in gap at elbow due to severed tendon
- For proximal long head tear, mild weakness can persist in elbow flexion
- For distal tears, significant loss of supination ...
Log In to View More
If you don't have a subscription, please view our individual subscription options below to find out how you can gain access to this content.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
AccessPhysiotherapy Full Site: One-Year Subscription
Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.
Pay Per View: Timed Access to all of AccessPhysiotherapy
24 Hour Subscription $34.95
48 Hour Subscription $54.95
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.