Traumatic Conditions (Other): Biceps Tendon Ruptures

Ruptures of the biceps tendon can take two forms:

Long head of the biceps tendon

Rupture of the long head of the biceps tendon leads to bunching of the muscle lower in the arm – the so-called ‘Popeye’ sign. It occurs through a degenerate tendon in the upper part of the bicipital groove.

In the majority of cases surgical repair is not indicated.

Distal biceps tendon

Distal biceps ruptures occur in a younger age group and usually have no premonitory symptoms. The rupture typically occurs during a strong contraction and the tendon avulses from its usual point of insertion on the radial tuberosity.

The injury is more common in those who have taken anabolic steroids, with muscle strength developing faster than tendon strength.

It is important to consider repair early, as late reconstruction is very difficult. If repair is not carried out supination is significantly affected, with weakness that is most noticeable to the patient when the dominant arm is affected.

Learning bite

Do not confuse the management of proximal and distal biceps tendon injuries, as the latter should be considered for surgery.