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Proximal Biceps Rupture

The proximal (at the shoulder) biceps tendon may rupture or tear from its attachment to the bone. Almost always this involves the long head of the biceps muscle, the one that attaches to the glenoid or socket. The short head almost always remains attached.

Proximal Biceps Rupture Hero Image 2

The proximal (at the shoulder) biceps tendon may rupture or tear from its attachment to the bone. Almost always this involves the long head of the biceps muscle, the one that attaches to the glenoid or socket. The short head almost always remains attached.

What causes Proximal Biceps Rupture?

Most proximal biceps tendon ruptures occur as a result of wear and tear over time. This can be worsened by repetitive shoulder activities. Often the same process that causes impingement and rotator cuff syndromes can lead to damage and eventually tearing of the biceps tendon. Occasionally in young athletes the proximal biceps can rupture due to an injury such as a fall or lifting a heavy object.

Biceps tendon rupture is common in:

• Weightlifting

Symptoms

If you have any of these symptoms you may have a biceps tendon rupture.

• Sudden sharp pain in the front of the shoulder • Swelling or bruising in the front of the shoulder
• A “pop eye” deformity of the biceps muscle.

Often the injury is quite painful but usually the arm begins to feel better in a few days.

When to see a doctor

If you suspect you have a biceps tendon rupture and you want to consider surgical repair of the tendon you should see your physician. While surgical repair is usually not recommended, it may be appropriate in young athletes who may be bothered by mild persistent weakness in the arm. As surgical repair works best when performed soon after the injury you should see your orthopedist as soon as you can.

In many cases, biceps ruptures are associated with rotator cuff disease. In these situations, you may rupture your biceps but still have pain in your shoulder. In that case you should also see your physician.

During your appointment your doctor will examine your shoulder to see if you have a proximal biceps rupture. He/She will also look for signs of other shoulder problems.

In order to make a diagnosis your doctor may order

• X-ray
• Ultrasound
• MRI

Non-operative treatment

As the biceps is a unique muscle with two muscle attachments, most of the time proximal biceps muscle tears are treated nonoperatively. This is because only one tendon, the tendon of the long head, tears while the short head and its tendon remain attached. Athletes with these tears may have some persistent weakness but usually it is minimal.

If you suspect you have a proximal biceps rupture you should:

• Apply ice to the arm
• Rest the arm
• When the swelling and pain decreases you should begin a therapy program

Surgical Treatment

If you are a young athlete who suffers a proximal biceps tendon tear, surgical repair may be appropriate. Your physician will make a small incision over the biceps tendon and then bring it back up to the area in front of the shoulder and repair it back to the bone.

Recovery

If you elect to treat the proximal biceps tendon rupture nonoperatively and you have no other shoulder problems, the recovery can be quite quick. Usually you feel better in 3-6 weeks. If you elect to have the tendon repaired, the recovery is longer usually 3-6 months.

Sources

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