The biceps is a strong muscle in the upper arm that attaches to one of the forearm bones via its tendon. The main job of the biceps is to rotate the forearm, but it also contributes significantly to flexion or bending the elbow.
The Insertion of the tendon in to the elbow can rupture, usually due to sudden extension or straightening of the elbow whilst the muscle is contracting. Classically it happens whilst lifting large weights in the gym or when carrying very heavy objects.
What are the symptoms of distal biceps rupture?
This is usually pretty obvious! Patients frequently describe a ‘pop’ at the elbow at the time of injury as well as pain. Bruising often follows. It is also commonly seen with a loss of the normal contour of the muscle belly in the arm, a so called ‘popeye deformity’. You may also experience weakness and pain in bending the elbow and resisted rotation of the forearm.
How do you diagnose a distal biceps rupture?
Again this can be very obvious on clinical examination, however in cases where the tendon does not retract significantly, an ultrasound or MRI scan may be required to confirm the diagnosis.
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How do you treat a distal biceps rupture?
Most distal biceps tendon ruptures require surgical repair. This is done with a bone anchor and strong stitches to re-attach the torn tendon to the bone. It is done as a day case procedure under a general anaesthetic.
In patients with lower functional demands non operative treatment may be recommended. This will result in a reduction in power of rotational movements and bending the elbow, but this may not translate in to a significant problem in most activities, particularly if it is your non dominant arm.