A biceps tendon rupture is usually caused by injury or overuse of the arm. It is more common in men, especially those between the ages of 40 and 60, who are more likely to engage in activities that can put strain on the biceps.

In many cases, you may hear a “pop” sound at the elbow when the tendon tears. This is a warning sign that something has gone wrong, and often leads to pain, swelling, bruising, and difficulty moving the arm.

Once the tendon is torn, it doesn’t grow back or reattach to the bone. This means that the function of the biceps is compromised, and treatment is needed to repair the tendon back to the bone.

If you have a distal biceps tendon rupture, you might experience several signs and symptoms, including:

• A “pop” sound at the elbow at the time of injury.
• Pain around the elbow, especially when the arm is bent at a 90-degree angle and the palm is facing upward.
• Bruising or discoloration in the area around the elbow.
• A bulge in the upper arm, where the torn tendon may cause a visible lump.
• Weakness when bending the arm (flexing) or rotating the forearm (supination).
• Tenderness around the biceps tendon, especially when touched or moved.

When visiting your doctor, the visit typically starts with a complete medical history discussing your symptoms, how the injury occurred, your overall activity level, and goals for recovery. Your doctor will then conduct a thorough physical examination of the arm, including:

• Looking for bruising (also called ecchymosis) around the elbow or upper arm.
• Checking for tenderness around the biceps muscle and tendon.
• Feeling the area to see if the distal biceps tendon is still in place or if it is missing.
• Looking for muscle retraction in the upper arm (where the torn tendon may pull up, causing the muscle to look bunched or shortened).
• Testing strength in the arm by having you flex or rotate the forearm.

In some cases, your doctor may recommend an MRI to confirm the rupture or to check for any tendon degeneration (wear and tear).

Once diagnosed, the treatment for a distal biceps tendon rupture will depend on the severity of the injury and your activity level.

1. Non-Surgical Treatment – For some people, especially those who do not engage in high-demand activities (like athletes or people who lift heavy objects), surgery may not be needed. Physical therapy and rehabilitation may be enough to help improve strength and function in the arm.
2. Surgical Repair – However, for most people, surgery is recommended to re-attach the torn tendon to the bone. This surgery is often done using an open incision and may involve a second incision, depending on the severity of the injury.

Recovery from a distal biceps tendon rupture, especially if surgery is needed, can take time. Here’s what you can expect:

• Initial Rest: After surgery, you will likely need to wear a sling to keep your arm still for the first few weeks.
• Physical Therapy: This is a key part of the recovery process. Therapy will help improve your arm’s strength, flexibility, and range of motion. You will also learn exercises to help the tendon heal and prevent stiffness.
• Avoid Heavy Lifting: During recovery, it’s important to avoid heavy activities, like lifting objects, until your doctor clears you for these movements.

Full recovery can take several months, so it is important to be patient and follow your doctor’s instructions closely.