Rupture of the Biceps Tendon
Biceps tendon rupture is characterized by the rupture of the biceps tendon from the elbow or shoulder joint. The biceps muscle is the muscle in the anterior side of your upper arm that helps you bend your elbow and rotate your arm. The biceps tendon is a tough band of connective fibrous tissue that attaches your biceps muscle to the bones at the shoulder and the elbow.
Frequent overuse and injury leads to fraying of the biceps tendon, could eventually rupture the biceps tendon.
Biceps tendon rupture can either be partial or complete. In complete biceps tendon rupture, the biceps tendon will be completely torn away from the bone. Biceps tendon ruptures occurring at the shoulder joint are known as proximal biceps tendon ruptures, and biceps tendon ruptures occurring at the elbow joint are known as distal biceps tendon ruptures.
Biceps tendon rupture occurs mostly in people in age group of 40 to 60 who have developed micro tears from degenerative changes. Injury and overuse are often the most common causes of biceps tendon rupture in younger people. Falling hard on an outstretched arm, lifting heavy objects while at work or weightlifting, long time use of corticosteroid medications and nicotine dependence are also associated with biceps tendon ruptures.
The most common symptoms experienced by a patient with proximal biceps tendon rupture include:
- Sharp pain in the upper arm
- Tenderness and pain at the shoulder and elbow
- Trouble turning the palm up or down
- A popping sound in the upper arm
- A bulge at the upper arm above the elbow (also known as positive Popeye sign)
- Bruising to the upper arm
Your doctor diagnoses biceps tendon rupture after observing your symptoms and medical history. You may be asked to perform simple exercises in order to see which movements elicit pain or weakness. In addition to physical examination, imaging studies such as X-rays or MRIs may be ordered to obtain a detailed view of the biceps muscle and the shoulder joint.
Nonsurgical treatment: Nonsurgical treatment is an option for patients who are elderly, inactive, contraindicated for surgery owning to other medical conditions or whose injury is limited to the long head of the biceps tendon (close to the shoulder). Nonsurgical treatment includes:
- Rest: A sling is used to rest the shoulder. In addition, you are advised to avoid heavy lifting and overhead activities.
- Ice: Applying ice pack 20 minutes at a time, 3 to 4 times a day, helps reduce swelling.
- Medications: Non-steroidal anti-inflammatory medicines help reduce the pain and swelling
- Physical and occupational therapy: Strengthening and flexibility exercises help restore strength and mobility to the shoulder joint.
Surgical treatment: Surgery may be indicated for patients who have failed conservative measures. Some of the minimally invasive procedures available for biceps tendon rupture include:
Direct repair: Direct repair surgery is performed soon after the rupture of the biceps tendon as it reduces the risk of tendon retraction. During direct repair, the surgeon pulls the torn end of the distal biceps tendon through an incision just above the elbow and reattaches it by suturing it to the rim of the radial tuberosity.
Suture anchor method: When the biceps tendon ruptures off the forearm bone (radius) it retracts up the upper arm. A small incision is made over the point of attachment of the biceps tendon on the upper forearm. The retracted biceps tendon is pulled through this incision and secured with suture anchors at the radius.
Tension slide technique: Tension slide technique makes use of a cortical button for the repair of the torn biceps tendon. The tensioning technique draws the tendon to the distal cortex of the bone socket. The tendon is pulled and attached to the elbow bone and pinned to the bone using a cortical button.
Biceps tendon repair surgery is minimally invasive and is often considered safe. One of the rarest complications includes re-rupture of the repaired tendon.
However, serious medical problems due to biceps tendon rupture can lead to ongoing health concerns, prolonged hospitalization, and rarely death. As with any surgery there are potential medical complications involved. These include:
- Risks of anesthesia
- Allergic reaction to medications
- Blood loss requiring transfusion with its low risk of disease transmission
Recovery Pain medicines are prescribed to manage pain. A shoulder sling may be recommended for several weeks. A rehabilitation program consisting of physical and occupational therapy may also be advised to restore motion and for further strengthening of the muscles.
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Houston Elbow Specialists
The physicians at Advanced Orthopedics and Sports medicine who specialize in elbow treatment are recognized globally for their expertise. Advanced Orthopedics and sports medicine has numerous Board Certified/Eligible physicians who are thoroughly educated in the latest treatment techniques both surgical and conservative. They are well versed in advances in elbow treatments including endoscopic ulnar nerve release at the elbow.
Drs Elbaz and Brooks now perform Platelet-Rich Plasma (PRP) injections for the treatment of medial and lateral epicondylitis, ulnar collateral ligament sprain or tear. PRP stimulates a more rapid healing of tendon, ligament, muscle and bone.
Contact us today to Schedule an Appointment or call us at 281-955-2650 to learn more about our Elbow Treatment Services.
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Thank you for the opportunity to express how pleased I am with the excellent care of Stacy A. Bacon, M.D. I have confidence in her ability to care for me as she successfully partially replaced a broken hip 10 years ago, 2007. I also want to compliment Cheryl who set up the appointment. She represents Advanced Orthopaedics & Sports Medicine very well.
It’s been over 8 years since Dr. Bacon replaced by right ankle. I still can’t thank her enough for the years of pain free walking I have done since! And I’m still going strong! I had numerous breaks in my ankle due an auto accident, repaired/set by a different doctor, after multiple surgery’s, I was still limping, in great pain every day. Then I found Dr. Bacon, now, no more pain, NONE, and no more limping after this ankle replacement. I rave about her constantly and would recommend her to anyone who has a foot or ankle issue
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I would highly recommend Dr. Cubbage if you are having any type of spinal issues. I have seen Dr. Cubbage several times over the last 3 years for lumbar pain and numbness in my left leg. Dr. Cubbage explained my diagnostic results in such a way that it was easy for me to understand. He patiently answered all my questions and explained my options. Fortunately, Dr. Cubbage has been able to manage my pain with conservative treatment but know surgery is inevitable. When that time comes, I would choose no other than Dr. Cubbage! And it’s a plus that he has such a kind and caring staff.
For the first time in many years and many knee operations on one leg I am without any knee pain. This is a result of a procedure performed by Dr. Patel.
I made an appointment to see Dr. Patel on the recommendation of Dr. Tanous following knee replacement and several months of continued pain. Dr. Patel explained the procedure to me and explained how we would proceed. The first procedure was to determine if I would be a good candidate for the second procedure. After the first procedure my pain was anywhere from 0 and 5. Dr. Patel explained to me at follow-up that I was not a good candidate for the second procedure due to my pain level being above the 0 to 3 level. After talking for a while I said “any relief would be better than the pain I had been having.” With this it was agreed that I would have the second procedure. It has now been 6 days since the procedure and I am without any pain.
I realize this is only a few days of not being able to sleep, with a pillow between my knee or under my leg at night. I know the pain may come back at anytime but until then it has been well worthwhile. I hope it will last 6 months, if not, I will have the procedure again after 6 months.
Thank you Drs. Patel and Tanous.
Outstanding Physicians. I’ve had two surgeries here, one on my foot with Dr. Bacon, and an extensive back surgery with Dr. Cubbage. I’m new to the area and my wife found me these surgeons. I have to say that each surgery I’ve had with these physicians have had excellent results. I was very pleased with my foot surgery and decided to see Dr. Cubbage for my back. Other surgeons I’ve seen regarding my back only gave me a 50/50 success rate. I have to say, the low back surgery with Dr. Cubbage was like a miracle. Right away, I noticed a difference and I’ve continued to improve rapidly. I’m almost eight weeks out and I haven’t felt this good in years. I’d like to thank Dr. Stacy Bacon for my foot surgery and Dr. Matthew Cubbage for my low back surgery. Without these drastic results, I’d not be walking today. Thank you all very much and I highly recommend your services. God bless you all.
Dr. David R. Mack replaced my right hip in June 2009, and my left in October 2010. I am already able to go places and do things on my own again. His excellent staff are very caring and helpful throughout the entire process, including recovery. The out-patient therapy is the best. I am walking very well now and am very pleased to have my life back. Thank you so much Dr. Mack and your great staff! Sincerely,
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When I started, I couldn’t put any weight on my right leg and now I can do virtually anything. While I hope to not need future therapy, this is without a doubt the place I will return to in the future.