The biceps (bicep brachii) is a muscle along the upper arm, between the shoulder and the elbow. It has two-heads attached to the shoulder (scapula) and they join to form a single muscle, which is attached to the upper part of the forearm. A bicep rupture usually occur on the long head which is attached to the shoulder, although it can happen at the other two attachment sites.
- Sudden onset of pain on the front-facing part of the shoulder, upon exertion. May be accompanied by “pop” sound.
- Recurrent pain and soreness on the front-facing part of the shoulder
- Palpable mass between shoulder and elbow
- Rapid stress, exertion and excessive weight lifting can cause acute rupture
- The proximal biceps tendon can also rupture due to a weakened tendon caused by inflammation which comes from the impingement of the subacromial region. If not given time to recover, continuous overuse may then lead to chronic microtrauma, which is fraying of the tendon. This weakens the tendon hence predisposing it to rupture, if not managed or left untreated.
- The distal bicep tendon can rupture due to persistent cubital bursitis
For conservative management of biceps rupture, rest the affected joint in the acute stage. Control swelling with cold packs and treat inflammation with nonsteroidal anti-inflammatory drugs (NSAIDs).
For surgical repair, the tendon can either be attached with stitches through holes drilled in the bone, or metal implants can be used to attach the tendon to the bone.
The post-surgical rehabilitation will be planned by the surgeon and usually involve physiotherapy sessions. This is to re-establish the normal range of motion that the arm is capable of and to also strengthen the muscles supporting the shoulder joint.