Biceps injuries are any injuries that cause damage to the biceps muscle located at the front of the upper arm or the two tendons that connect it to the scapula bones of the shoulder and the radius bone of the elbow. Biceps injuries include tendon tears or tendonitis (tendon inflammation).
Symptoms
A biceps injury is usually accompanied by sudden and severe pain in the upper arm or at the elbow. If a tendon tears, you might hear a pop or feel a snapping or grinding sensation when you make specific arm movements.
Other symptoms of a torn or inflamed tendon include:
- Bruising on the upper arm or around the elbow
- Difficulty rotating your arm from palm-down to palm-up
- A sudden “Popeye” bulge in the contour of the upper arm
- Swelling, redness, and warmth around the joint
- A dull ache or tenderness at the site of the injury
- Pain that radiates or moves down the upper arm
- Weakness in the biceps muscle and joints
- Pain that worsens when lifting items overhead
Causes & Risk Factors
Tendons are strong, rope-like tissue that support your muscles by absorbing the impact when you run, jump, or make other movements. As we age, our tendons become less flexible, and repetitive arm motions and overuse can weaken them, increasing the risk of biceps injuries. When left untreated, tendonitis can make tendons more likely to tear.
Common causes and risk factors of tendonitis and tendon tears include:
- Work that requires frequent lifting, pulling, or wielding heavy tools and machinery
- Participation in sports like swimming, tennis, golf, or any activity that requires repeatedly throwing, hitting, swinging, or overhead reaching
- Sudden strain on the muscle and tendons, such as lifting heavy furniture
- Overtraining or poor posture when engaging in physical activities
- Direct trauma to the shoulder from a blunt force or fall
- Certain medical conditions, like diabetes or rheumatoid arthritis
- Certain medications, including statins and certain antibiotics
Diagnosing Biceps Injuries
A doctor can usually diagnose a biceps injury through a physical examination and a few questions about your job, hobbies, and physical activities. Clinicians can typically determine whether you have tendonitis or a torn tendon by assessing your pain level and difficulty performing a series of arm movements.
In some cases, a doctor may order an X-ray to rule out a fracture or perform a joint aspiration to rule out other conditions, such as gout or infection. If a doctor suspects you have a torn tendon, they may request an ultrasound or MRI to better understand the nature and extent of your biceps injury.
Treatments for Biceps Injuries
Depending on the severity of your condition, over-the-counter pain medication, ice, and temporary inactivity may be enough to treat a biceps injury. In other cases, your doctor might recommend additional medications and therapies. If your injury is more severe or does not improve with non-surgical treatments, they may recommend surgery.
Non-Surgical Treatments
- Rest: avoiding all activities that cause pain to the injured area until the biceps injury heals.
- Pain-relieving medications: taking nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, or naproxen.
- Steroid injections: injecting cortisone directly into the tendon to help alleviate pain.
- Regenerative injection therapy: injecting platelet-rich plasma to the injury site to help support healing.
- Physical therapy: engaging in specific exercises to stretch and strengthen the muscles and tendons and reduce the risk of repeat injuries.
Surgical Treatments
- Distal biceps tendon repair surgery: reattaching a torn biceps tendon to the radius bone in the lower arm. This option is usually only possible in the first six weeks after injury, before the tendon atrophies or scars.
- Distal biceps tendon reconstruction surgery: placing a grafted tissue between the biceps tendon and the bone to restore the tendon’s function. This option is usually required if scar tissue has formed or the muscle has atrophied.
After surgery, patients should wear an immobilizing splint and sling for at least two weeks and an elbow brace for another four weeks. Many patients will also require physical therapy to overcome stiffness, re-strengthen the muscle and tendons, and recover their range of motion.
