What Is a Distal Biceps Tendon Tear?
The distal biceps tendon connects the biceps muscle in the upper arm to the radius bone in the forearm. It plays a crucial role in forearm rotation (supination) and elbow flexion. A tear of this tendon usually occurs near its attachment at the elbow and can result in sudden loss of strength, particularly when turning the palm upward or lifting.
Unlike partial tendonitis-type overuse injuries, this injury is often acute and traumatic, typically affecting middle-aged men during forceful lifting or pulling activities.
Causes and Risk Factors
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Sudden, forceful extension of a flexed elbow (e.g., trying to lift or catch a heavy object)
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Heavy lifting or pulling exercises
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Use of anabolic steroids or smoking (can weaken tendons)
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More common in men ages 40–60
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Dominant arm is usually affected
Symptoms
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A sudden “pop” at the elbow followed by sharp pain
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Bruising and swelling near the front of the elbow
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Visible change in the shape of the upper arm (the biceps may appear “bunched up”)
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Difficulty turning the forearm (supination)
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Weakness when bending the elbow or lifting objects
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Tenderness at the front of the elbow
Diagnosis
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Physical exam with resistance testing (e.g., hook test, supination test)
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Imaging:
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MRI confirms complete or partial tendon rupture
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Ultrasound may also help visualize the tear
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Treatment
Non-Surgical Treatment
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Typically only recommended for older, low-demand patients or those with significant medical risks
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Involves activity modification, physical therapy, and monitoring for compensation from other muscles
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Patients may experience long-term weakness, especially with rotational movements
Surgical Treatment
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Most patients, especially active individuals, benefit from surgical reattachment of the tendon to the radial bone
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Performed through a small incision near the elbow
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May involve suture anchors or button fixation techniques
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Aims to restore full strength and function
Recovery Timeline
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Initial healing phase: 4–6 weeks with restricted use and bracing
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Physical therapy begins gradually after immobilization
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Strength and function return over 3–6 months
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Most patients regain excellent arm use, especially when surgery is done promptly
Expert Treatment at Kerlan Jobe Institute
At Kerlan Jobe Institute, our orthopedic specialists are highly skilled in diagnosing and treating distal biceps tendon ruptures. We prioritize early and accurate intervention to help patients regain maximum strength and avoid long-term limitations.