Proximal Biceps Tendon Rupture

The biceps muscle is a muscle in the front of the arm between the shoulder blade and the elbow. The two heads of the biceps muscle attach on the scapula and join to form a single tendon attachment on the radial tuberosity. The main function of the biceps is to flex and supinate the forearm.

The most common cause of a proximal biceps rupture is a sudden injury, such as lifting a heavy object overhead. Males older than 30, nicotine use, and oral steroid use are risk factors for rupturing the biceps tendon.

• Feeling a pop directly in front of the shoulder, followed by intense pain.
• Swelling, bruising in front of the upper arm
• Arm deformity with “balled up” muscle around the elbow. (“Popeye arm”)
• Arm weakness, especially forearm supination

It is important to diagnose a proximal biceps tendon rupture immediately after injury. You can either see your orthopedic surgeon or visit an orthopedic urgent care. Our Walk-In Anytime Ortho Orthopedic Urgent Care Clinic (link to anytime ortho page) is a convenient affordable way to get an accurate diagnosis and treatment without having to go through the hassle and costs of a hospital emergency room.

Proximal biceps tendon ruptures are diagnosed after thorough discussion and physical exam with an orthopedic specialist. X-rays of the shoulder will not show biceps tendon ruptures, but are used to rule out other shoulder problems. A shoulder MRI can diagnose if a rupture is full or partial.

• Rest
• Anti-inflammatory medications
• Steroid or “cortisone” injections can reduce tendon inflammation and reduce or eliminate symptoms
• CBD – CBD is a natural, nonsurgical way to help treat pain and tendon inflammation
• PRP and Stem Cell injections are nonsurgical ways to treat pain and inflammation associated with proximal biceps tendon ruptures.
• Physical Therapy
• Arthroscopic Surgery or open Biceps Tenodesis

Surgical repair of the proximal biceps tendon is recommended if pain or symptoms continue despite non-surgical management. This involves either an arthroscopic surgery or open surgery to reattach the biceps tendon.

Immediately after surgery, the shoulder is immobilized in a sling. It is recommended to start working with a physical therapist to begin range of motion exercises. At about six weeks the patient can start more active strengthening exercises. Most people have regained full range of motion and strength by 3 months after surgery.