Distal Biceps Tears
The biceps is a muscle originating from two locations in the shoulder. The long head of the biceps originates from inside the shoulder joint attaching to the labrum and the short head of the biceps originates at the tip of the coracoid process of the scapula. The biceps muscle bellies are located on the front of the arm and help to flex the elbow and rotate the forearm through an attachment to the radius (forearm bone) at the elbow. Both ends of the biceps can be injured either from a fall, sports injury or cumulative trauma causing wear. Injuries to these tendons can cause pain and weakness causing loss of motion, loss of function and impairment.
The biceps tendon can be torn both partially or completely. This is usually associated with a popping sensation and the development of a noted “Popeye” deformity of the biceps from shortening of the muscle. When the biceps ruptures at the elbow the impairment associated with the rupture (complete tear) causes more significant limitations. There is usually a 30% loss of flexion strength at the elbow and a 40% loss of strength in supination of the forearm (rotation of the hand and wrist outwards).
Treatment of the Injured Biceps
Tendonitis and partial tearing of the biceps can often be successfully treated with non-operative measures. This can include observation, avoidance of the causative activities, icing and anti-inflammatory medications (oral and injectable). Additionally, physical therapy exercises can help to maintain range of motion and strength in the shoulder and arm. If a reasonable course of non-operative treatment has failed then surgical intervention may be indicated.
A ruptures of the biceps tendon at the elbow usually requires surgery, a distal biceps tendon repair. The significant impairment associated with this rupture will necessitate repair in order to return the arm to an acceptable degree of function. Dr. Lenarz performs this procedure through a single incision on the forearm. The surgery will need to be performed within the first two to three weeks after the injury to avoid tendon scarring which can significantly complicate the surgery.