The bicep tendons are responsible for keeping the bicep muscle attached to bones in the elbow and shoulder. In the shoulder, there are two tendons that attach the top of the bicep muscle to the shoulder socket, also called the glenoid. The bicep tendon can tear or rupture in the shoulder.
There are two types of bicep tendon tears. Partial tears do not completely split the tendon, whereas complete tears pull the tendon apart into two pieces. Sometimes, a partial tear may develop into a complete tear if left untreated. The long head of the bicep tendon, which is one of the two tendons that attach in the shoulder, is more susceptible to injury. Since the bicep is attached in two places, it can still be used even if one of the tendons is torn.
Like many other tendon injuries, bicep tendon tears are mainly caused by either an acute trauma, such as a fall, or overuse. Overuse of the shoulder joint through athletics or manual labor can lead to degeneration of the tendon that happens over time. Having another shoulder condition, such as a rotator cuff injury, also puts added stress on the tendon, so a torn tendon may be the result of another injury.
There is an increased risk for bicep tears with age, partially because older age means more use of the tendons. Risk also increases with frequent heavy lifting and smoking.
Symptoms and Diagnosis
A thorough physical exam will be performed by a physician that specializes in treatment of the upper extremities, such as Dr. Leah Urbanosky of Hinsdale Orthopaedics. Many times, a complete tear may be very visible upon first glance due to the nature of the injury. The doctor will check for pain during certain motions and examine the muscle while it contracts. Some signs of a bicep tear is:
• Sharp pain in the upper arm
• “Popeye” bulge, where the muscle is more visibly defined upon contraction
• A potential snapping noise
• Tenderness in the shoulder
• Inability to rotate the arm fully
• Extreme cramping within the upper arm upon use
• Surface bruising in the middle of the bicep area
Many times, a bicep tear will accompany another injury, so a physician may check for other conditions also. An x-ray may be used to rule out the possibility of other conditions, but an MRI will most likely be used to view the soft tissues.
Sometimes, a bicep tear can be treated with simple, nonsurgical measures. Ice and common anti-inflammatory medications may treat the pain in combination with rest. Mild physical therapy may restore movement and provide the necessary support to return to daily activities. For the many patients, non-surgical treatment is all that is needed.
For example, in 1997, John Elway, former NFL quarterback for the Denver Broncos, ruptured his right bicep tendon three weeks before the Super Bowl. With non-surgical treatment and therapy, he was able to play in the game nineteen days later and ended up winning his fourth Super Bowl title without having to undergo an operation.
Surgery is needed in some cases, especially among athletes or those who perform manual labor. A physician such as Dr. Urbanosky may suggest a minimally invasive procedure to repair the tendon and reattach it to the bone of the shoulder socket. The surgery is typically performed arthroscopically, or with a small camera and minimal incisions. There are very few complications with this procedure. Sometimes, the damaged part of the bicep is simply removed to eliminate symptoms, and other times the tendon is released from its attachment to the glenoid. Both of these alternate options restore the arm and shoulder to full use.
Common rehabilitation exercises are recommended after surgery, and a sling is necessary for a few weeks after surgery to ensure proper healing. The healing process may be slow due to the nature of the injury, but surgery can correct issues and return the patient to full activity.
If you think that you may be experiencing a problem with your bicep, contact Dr. Leah Urbanosky for a consultation: (815) 462-3474.