Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Biceps distal tearBiceps 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 armS46.119A Strain of muscle, fascia and tendon of long head of biceps, unspecified arm, initial encounter ++ 4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with connective tissue dysfunction4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation1 +++ Description ++ Rupture of the biceps brachii tendon, either complete or partialDistal rupture will cause swelling, bruising, and a gap in front of elbow, created by absence of tendonAvulsion of the tendon from the radial tuberosityProximal 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 +++ Essentials of Diagnosis ++ History and clinical examDiagnosis of proximal tear is often easily visible with observation due to bulge left by deformed muscle (“Popeye sign”)Diagnosis of distal tearPalpation of gap at elbowManually testing supination strength compared with uninvolved sideSudden event traumaPartial tears can be harder to diagnose and may require manually testing bicep muscle for signs of pain with activation of muscleOccurs from a sudden high force, typically with weightlifting (i.e., bicep curls or activities with elbow flexion), eccentric forceMay arise from a repetitive type activity that leads to a gradual degenerationMRI can be used to show both partial and complete tendon tears +++ General Considerations ++ History of repetitive motion, especially activities overheadCommon in swimming, tennis, baseball, and with occupational activities involving repetitive or overhead activity due to microtraumaSmoking affects overall nutrition of tendon due to nicotine side effectsCorticosteroid medications have been linked to decreased muscle and tendon strength +++ Demographics ++ Predominately individuals involved in repetitive activities in sports or workLong head tears are typically seen in the 4th decade of life +++ Signs and Symptoms ++ Patient will describe an audible pop or snap associated with injurySharp pain occurring suddenly in upper armEcchymosis, swelling, bulging of upper armPain and tenderness with palpation of shoulder and elbowDiminished strength of elbow flexion and supinationAppearance of bulge (“Popeye muscle”) with indentation closer to shoulder for proximal tearDistal tear will result in bulge in upper part of arm due to recoiled, shortened tendonDistal tear will result in gap at elbow due to severed tendon +++ Functional Implications ++ For proximal long head tear, mild weakness can persist in elbow flexionFor ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.