Biceps Tendon Tear (Shoulder)
The biceps muscle is in the upper arm and has multiple functions including bending and rotating the elbow
and keeping the shoulder stable. There are two shoulder attachments of the biceps, one at the coracoid and
one at the glenoid. Injury most commonly occurs to the head that attaches at the glenoid. It is found most
easily in its groove below the pectoralis muscle as it attaches to the upper arm (humerus).
Causes & Symptoms
Injuries to the biceps tendon at the shoulder usually occur from chronic wear, while injuries to the
biceps tendon at the elbow usually occur when the elbow is forced straight against resistance.
Symptoms of a biceps tendon tear at the shoulder include a “pop”, bruising, pain, an swelling.
The pain and swelling often reduces over a week or two though in some people a small bulge may be
noticed in the arm after a biceps tendon tear. In those who perform a lot of forearm rotational activities some weakness may be noted.
Evaluation & Treatment
Evaluation begins with a history of the injury, physical examination including special maneuvers,
and X-rays to rule out other injuries. An MRI is helpful to distinguish a partial from a complete tear.
Tears of the biceps at the shoulder are most often treated nonsurgically with pain
and arm bulging resolving over time. Surgical treatment is considered in those who have
painful cramping, are athletes or laborers, or for those who the cosmetic deformity is unacceptable.
Initial treatment includes ice, rest, and anti-inflammatory medications. Surgical fixation is done as
an outpatient procedure. Physical therapy is begun post operatively with an anticipated return to full activity at 2-3 months.