The biceps tendon attaches the biceps muscles to the shoulder, providing leverage for lower arm movement. Tears or ruptures of the biceps tendon can occur from lifting heavy objects, falling on an outstretched arm or playing contact sports. A torn biceps tendon causes pain and swelling.
Biceps tendon tears can be either partial or complete.
A complete tear of the long head at its attachment point in the glenoid.
Partial tears. Many tears do not completely sever the tendon.
Complete tears. A complete tear will split the tendon into two pieces.
In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object.
The long head of the biceps tendon is more likely to be injured. This is because it is vulnerable as it travels through the shoulder joint to its attachment point in the socket. Fortunately, the biceps has two attachments at the shoulder. The short head of the biceps rarely tears. Because of this second attachment, many people can still use their biceps even after a complete tear of the long head.
When you tear your biceps tendon, you can also damage other parts of your shoulder, such as the rotator cuff tendons.
There are two main causes of biceps tendon tears: injury and overuse.
If you fall hard on an outstretched arm or lift something too heavy, you can tear your biceps tendon.
Many tears are the result of a wearing down and fraying of the tendon that occurs slowly over time. This naturally occurs as we age. It can be worsened by overuse – repeating the same shoulder motions again and again.Overuse can cause a range of shoulder problems, including tendonitis, shoulder impingement, and rotator cuff injuries. Having any of these conditions puts more stress on the biceps tendon, making it more likely to weaken or tear.
Your risk for a tendon tear increases with:
- Age. Older people have put more years of wear and tear on their tendons than younger people.
- Heavy overhead activities. Too much load during weightlifting is a prime example of this risk, but many jobs require heavy overhead lifting and put excess wear and tear on the tendons.
- Shoulder overuse. Repetitive overhead sports – such as swimming or tennis – can cause more tendon wear and tear.
- Smoking. Nicotine use can affect nutrition in the tendon.
- Corticosteroid medications. Using corticosteroids has been linked to increased muscle and tendon weakness.
- Sudden, sharp pain in the upper arm
- Sometimes an audible pop or snap
- Cramping of the biceps muscle with strenuous use of the arm
- Bruising from the middle of the upper arm down toward the elbow
- Pain or tenderness at the shoulder and the elbow
- Weakness in the shoulder and the elbow
- Difficulty turning the arm palm up or palm down
- Because a torn tendon can no longer keep the biceps muscle tight, a bulge in the upper arm above the elbow (“Popeye Muscle”) may appear, with a dent closer to the shoulder.
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