Dr. Samuel Koo – Seattle, WA
How Do Bicep Tears Happen?
Two main causes exist. Traumatic injury can result in a partial or complete tear of the biceps. Falling on an outstretched arm or heavy lifting are the common mechanisms.
In many cases, biceps injuries occur over time. Just like arthritis of the knee and hip, age can cause degeneration in the biceps tendon as well. Repetitive motion, particularly overhead activities and lifting can weaken and cause injury to the biceps.
Symptoms of a Torn Bicep
People with biceps trouble can present with a variety of symptoms. In a traumatic injury, you can hear an audible pop or tearing of the tendon followed by bruising in the upper arm extending down to the elbow. This can sometimes result in a bulge in the upper arm near the elbow called a “Popeye muscle” which indicates a complete tear.
Patients with partial tearing usually present with cramping of the muscle and pain in the front of the shoulder. You may even have difficulty turning the palm up and down due to the pain.
Diagnosing Bicep Tears
A biceps tear is diagnosed with a combination of the physical exam and diagnostic imaging (MRI). A complete tear is usually obvious due to the development of the “popeye muscle.” However, partial tears can be difficult to detect. On the physical exam, weakness and pain may be evident with biceps testing. Pain with rotation of the lower arm and flexion of the elbow are common signs. The MRI can be helpful in visualizing a partial tear or tendon subluxation/dislocation.
Biceps tendon injuries often signal the presence of other pathology. It is important to evaluate for rotator cuff injuries, impingement and tendonitis in those with biceps tendon symptoms. Biceps injury usually occur in conjunction with other injuries (rotator cuff, impingement).
How Are Bicep Tears Treated?
In many cases, non-operative treatment can provide pain relief and improve the daily function of the shoulder. Some of the commonly prescribed treatment include; rest, ice, avoidance of aggravating activity, anti-inflammatory medications, cortisone injections and physical therapy.
People with complete tears may experience mild weakness with bending the elbow, rotating the lower arm (supination) and muscle spasms. Older and less active patients, if more critical structures are not damaged (rotator cuff), may find non-operative treatment to be a reasonable option.