Biceps Tendon Tear at the Shoulder

Understanding Biceps Tendon Tear at the Shoulder

The biceps has two tendons at the shoulder. The long head is the one that typically tears, because it passes through the shoulder joint and over the top of the arm bone. Tears can be partial or complete. Because the short head usually remains attached, many people keep good arm strength after a complete long head tear.

Tears happen from a fall on an outstretched arm or lifting something heavy, or gradually as a worn tendon frays. Most occur in people over 40, often alongside rotator cuff tears or impingement. When the tendon tears completely, the muscle can slide down the arm and form a bulge known as a "Popeye" deformity.

Most complete tears are treated without surgery and patients regain good function. Surgery to reattach the tendon (biceps tenodesis) is considered for persistent cramping or pain, for cosmetic concerns, for workers and athletes who need full strength, or when another shoulder problem requires surgery.

Causes & Risk Factors

• Falling on an outstretched arm or lifting a heavy object
• Gradual tendon wear and overuse
• Repetitive overhead sports and work
• Smoking and corticosteroid use
• Associated rotator cuff tears and impingement

Symptoms

Common signs and symptoms of Proximal Biceps Tear include:

• A sudden sharp pain and sometimes a pop at the upper arm
• Bruising from the middle of the upper arm toward the elbow
• A bulge in the upper arm ("Popeye" deformity)
• Cramping of the biceps with strenuous use
• Some weakness turning the palm up or bending the elbow

Treatment Options

Treatment for Proximal Biceps Tear depends on the severity of your condition and may include:

• Ice, rest and anti-inflammatory medications
• Physical therapy to restore strength and motion
• Biceps tenodesis to reattach the tendon
• Treatment of associated rotator cuff or labral problems