A ruptured biceps tendon occurs when the long head of the biceps muscle is pulled from its attachment in the shoulder or the elbow. This often happens in older adults with a long history of shoulder impingement. Often, the injury is the result of a trivial event such as lifting a heavy item or an episode of a jerking motion while the biceps is flexed. It is uncommon in young adults unless they are active in weight lifting or throwing sports such as baseball.
With a biceps tendon rupture, patients notice a deformity of the biceps muscle with what usually appears as a bulge in the arm. This injury is commonly accompanied by a loud snapping sound, resulting in bruising at forearm or elbow. Patients often report difficulty turning doorknobs, weakness in lifting items, or pain with twisting motions of the wrist.
An MRI (magnetic resonance imaging) is often ordered to confirm a ruptured tendon. Biceps tendon ruptures that occur at the shoulder do not require surgery, but some people prefer to have them repaired to correct the cosmetic deformity. Those with a biceps tendon rupture at the elbow attachment will need to undergo surgical repair and reattachment. Patients can lose approximately 10% of elbow flexion and have decreased forearm strength if not treated surgically. For example, it may be difficult to perform motions like using a screwdriver.