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Biceps Tear Specialist
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is a Biceps Tear?
A biceps tear is a condition involving the rupture or tearing of the biceps tendon, which helps arm movement. The biceps muscle, located in the front of the upper arm, aids the arm’s ability to bend the elbow and rotate the forearm. This muscle has two tendons, one attached to the bones in the shoulder and one at the elbow.
Biceps tears can be classified into two types based on their location: proximal biceps tendon tears, which occur near the shoulder, and distal biceps tendon tears, which occur near the elbow. The majority of these tears are proximal.
Causes of Biceps Tears
Biceps tears are typically caused by injury or overuse.
Injury-Related Causes
Injuries leading to biceps tears often occur during activities that involve sudden, intense strain on the biceps muscle and tendon. Common scenarios include:
- Falling onto an outstretched arm, placing immediate and intense pressure on the biceps tendon.
- Lifting a heavy object, particularly when done abruptly or without proper technique. This sudden overload can cause the tendon to tear.
Overuse Causes
Overuse injuries develop gradually and are common in athletes or individuals with jobs requiring repetitive arm movements. Key factors include:
- Age-related wear and tear: As individuals age, tendons naturally lose flexibility and strength, making them more susceptible to tears.
- Repeated overhead activities: Regular engagement in activities or sports that involve repetitive arm lifting, such as weightlifting, swimming, or tennis, can gradually strain the biceps tendon.
- Chronic conditions: Long-standing shoulder problems like rotator cuff injuries or shoulder impingement can put additional stress on the biceps tendon, increasing the likelihood of a tear.
Symptoms and Signs
Symptoms vary depending on the severity and type of the tear.
- Sudden, Sharp Pain: This is often the first sign of a biceps tear, especially in cases of acute injury. The pain is typically localised in the upper arm and may be accompanied by a snapping sound or sensation.
- Visible Bruising or Swelling: Following the tear, bruising and swelling may appear on the upper arm, sometimes extending down towards the elbow.
- Muscle Cramping: Particularly during strenuous use of the arm, individuals might experience cramping of the biceps muscle.
- Weakness in Shoulder and Elbow: A torn biceps tendon can lead to reduced strength in the shoulder and elbow, affecting the ability to lift objects or perform certain movements.
- Difficulty in Arm Rotation: Turning the hand from palm up to palm down can become challenging or painful due to the impaired function of the biceps muscle.
- Physical Deformity: In some cases, particularly with complete tears, a bulge in the upper arm above the elbow, known as a “Popeye Muscle,” may become visible. This occurs due to the retraction of the torn muscle.
Diagnosis
Diagnosing a biceps tear involves a combination of medical history review, physical examination, and imaging tests.
- Medical History: This is the initial step, which includes a thorough discussion of symptoms and a review of the patient’s medical history.
- Physical Examination: During the physical examination, the doctor will assess the arm for signs of a biceps tear, such as deformity (e.g. the “Popeye Muscle”), tenderness, swelling, and bruising. The doctor may also perform specific movements or tests to evaluate the strength and range of motion in the arm.
- X-rays: While X-rays cannot directly visualise the biceps tendon, they are useful in ruling out other potential causes of arm pain, such as bone fractures.
- Magnetic Resonance Imaging (MRI): An MRI is more effective in visualising soft tissue structures. It can provide detailed images of both partial and complete biceps tendon tears, as well as any other associated shoulder injuries.
Non-Surgical Treatment Options
Non-surgical treatment can be an effective approach for those with less severe injuries or specific lifestyle considerations. These options focus on relieving pain, reducing inflammation, and improving function.
- Rest and Activity Modification
Avoid activities that exacerbate the pain or strain the biceps tendon. This includes heavy lifting and repetitive overhead movements. In some cases, a brief period of immobilization, such as using a sling, may help protect the arm and aid in the healing process. - Ice Therapy
Applying ice packs to the affected area can help reduce swelling and alleviate pain. Use ice for 20 minutes at a time, several times a day, ensuring that the ice is not applied directly to the skin. - Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, or naproxen can be used to manage pain and reduce inflammation. - Physical Therapy
Tailored exercises help restore movement, increase flexibility, and strengthen the shoulder. This can prevent further injury and aid in the recovery process. - Lifestyle and Ergonomic Adjustments
Making adjustments to daily activities and work environments can help manage symptoms and prevent aggravation of the injury.
Surgical Treatment Options
Surgical treatment is often reserved for more severe cases or when patients require full restoration of strength and function.
Arthroscopic Surgery |
This is commonly used for partial tears at the shoulder. It involves making small incisions and using a camera to guide the procedure. Tendons are repaired with sutures or anchors, depending on the extent of the tear. |
Open Surgical Repair |
This is typically required for complete tears or more complex injuries. It involves a larger incision to directly access and repair the torn tendon. It may be used for both proximal (shoulder) and distal (elbow) biceps tears. |
Distal Biceps Repair |
This procedure is necessary for tears near the elbow. It usually involves reattaching the torn tendon to the forearm bone using stitches or metal anchors. It is aimed at restoring the full range of motion and strength to the arm. |
Prevention Strategies
Preventing biceps tears involves a combination of lifestyle adjustments and exercise techniques.
- Gradual Strength Building: Incrementally increasing the intensity and duration of exercises can help avoid putting excessive strain on the biceps tendon. This approach should be used for activities like weightlifting, where sudden increases in weight or intensity can lead to injury.
- Proper Technique and Posture: Correct form during physical activities, especially in sports and weightlifting, can help distribute stress evenly across the muscle groups.
- Balanced Upper Body Training: Strengthening not just the biceps but also the surrounding muscles in the upper body can provide better support and reduce strain on the biceps tendon. This includes exercises for the shoulders, back, and chest.
- Regular Stretching and Warm-Up: Incorporating stretching and warm-up routines before engaging in physical activities can enhance flexibility and reduce the risk of muscle and tendon injuries.
- Avoiding Overtraining: Allowing sufficient time for rest and recovery between intense workout sessions can help prevent overuse injuries. This includes taking breaks during repetitive tasks or heavy lifting in occupational settings.
- Awareness of Age-Related Changes: As individuals age, muscles and tendons become less flexible and more prone to injury. Adjusting exercise routines and intensity accordingly can help mitigate these risks.
- Lifestyle Modifications: Avoiding or quitting smoking, as nicotine can affect tendon health. Be mindful of medication use, such as corticosteroids, which can impact muscle and tendon strength.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
Can a biceps tear heal on its own?
Partial biceps tears, especially those near the shoulder, can often heal with treatment methods like rest, ice therapy, and physical therapy. Complete tears, particularly near the elbow, usually require surgical intervention.
How do I know if I have a biceps tear?
Symptoms of a biceps tear can include sudden, sharp pain in the upper arm, a popping or snapping sensation, bruising, weakness in the arm, and difficulty with arm rotation. In some cases, a visible bulge (Popeye muscle) may appear on the upper arm.
What activities should I avoid if I have a biceps tear?
Avoid activities that exacerbate pain or stress the biceps tendon, such as heavy lifting, repetitive overhead activities, and certain sports movements. Your doctor can provide specific guidance based on the severity of your injury.
How long does it take to recover from a biceps tear?
Recovery time varies depending on the severity of the tear and the chosen treatment method. Non-surgical recovery can take several weeks to months, while surgical recovery may require a more extended rehabilitation period.
Can biceps tears be prevented?
While not all biceps tears can be prevented, the risk can be reduced by practising proper exercise techniques, building strength gradually, avoiding overtraining, and performing regular stretching and warm-up exercises.
Are there any long-term effects of a biceps tear?
Most people recover well from biceps tears, especially with appropriate treatment. Some may experience residual weakness or reduced range of motion.