Distal Biceps Tendon Tear at the Elbow

Understanding Distal Biceps Tendon Tear at the Elbow

The distal biceps tendon attaches the biceps muscle to the radius, just below the elbow. It is essential for turning the palm up (supination) and helps bend the elbow. Distal biceps tears are usually complete, separating the tendon from the bone, although partial tears also occur.

The tendon typically tears when the elbow is forced straight against resistance, such as catching or lifting a heavy object. These tears are uncommon and occur mostly in men over 30; the risk is higher with smoking and corticosteroid or anabolic steroid use.

Without repair, the arm typically loses about 30 to 40% of its strength for turning the palm up, along with some bending strength, and many people notice fatigue and cramping. For active patients, surgery to reattach the tendon to the radius is recommended, ideally within the first two to three weeks after injury. Repair is sometimes possible up to about six weeks; after that, the tendon often must be reconstructed with a donor graft.

Causes & Risk Factors

• Lifting or catching a heavy object with the elbow bent
• Weight training and heavy manual work
• Smoking
• Corticosteroid and anabolic steroid use

Symptoms

Common signs and symptoms of Distal Biceps Tear include:

• A pop at the elbow at the time of injury
• Swelling and bruising at the front of the elbow and forearm
• Weakness turning the palm up or bending the elbow
• A bulge in the upper arm from the retracted muscle
• A gap at the front of the elbow where the tendon should be

Treatment Options

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

• Surgical reattachment of the tendon to the radius
• Reconstruction with a tendon graft for chronic tears
• Rest, ice and physical therapy for patients who choose nonsurgical care
• Structured rehabilitation after repair