Biceps Tendon Tear (Elbow)

The biceps is a muscle in the front of the arm that allows for elbow bending, forearm rotation, and shoulder stability.

Injury to the biceps tendon at the elbow often occurs due to an acute injury resulting from a forced straightening of the elbow against resistance. This is different than injuries of the biceps at the shoulder which are usually from chronic wear.

Typical symptoms of a biceps tear at the elbow include a “pop” sound with initial pain, swelling, and bruising at the elbow. This often resolves over a few weeks. After swelling starts to reduce a bump or gap may be noticed at the front of the elbow. Forearm rotation may be weak.

Initial evaluation includes a medical history, physical examination, and x-rays to rule out associated injuries. Specialized physical examination testing may be done to evaluate for a gap in the tendon or decreased rotational strength. MRI’s are often done to distinguish a partial and complete tear and the level of tendon retraction.

Treatment of bicep tear at the elbow is based on the activity level of the individual and degree of tear. Most often full thickness tears in active individuals are treated surgically while those with lower activity levels may be treated nonsurgically. Nonsurgical treatment includes ice, rest, and anti-inflammatory medications. Nonsurgical treatment may lead to a 30-40% decrease in strength with arm rotation. Surgical treatment is done through small incision as an outpatient procedure. After repair biceps tendon takes 2-3 months to fully heal.