Bicep Tendon Rupture
The distal biceps tendon is a tendon at the front of the elbow that connects your biceps muscle to the radius bone in the forearm. It functions to help bend (flex) your elbow, bringing your hand up towards your shoulder, and to rotate your forearm so that your palm faces upwards, such as when you turn a screwdriver.
Over time, our tendons weaken. They can rupture (snap) without warning when a sudden force is applied, such as lifting a heavy object.
How serious is a distal biceps tear?
Initially it can be painful, with swelling and bruising, and you may feel weakness and pain when trying to bend your elbow or twist your forearm. The muscle may retract up your arm, causing a bulge known as a ‘Popeye sign’.
The swelling and bruising will settle in the first few weeks, and you can expect to regain a full range of movement in the arm. Although the tendon will not heal itself, in the majority of patients the weakness will improve, and there are other muscles that will compensate for the loss of biceps. Although your arm may always be a little weaker than before, for some people the loss of strength is not a problem.
However, some people will experience ongoing discomfort, cramps or fatigue with certain movements.
Does a distal biceps tear require surgery?
In some circumstances your surgeon may discuss repairing the tendon back onto the bone. This will depend on multiple factors such as hand dominance, occupation, hobbies and patient preference. The operation aims to restore strength and reduce the risk of pain or cramps.
The surgery reattaches the tendon to the bone and holds it in place to allow it to heal, and there are several different ways this can be done. Before deciding to proceed with surgical repair, your surgeon will explain the details of the procedure and the potential risks of surgery.
How long does it take to recover from surgery?
As a general rule you will be in a sling for 6 weeks after surgery, with specific rehabilitation exercises to do under the supervision of physiotherapy, and lifting nothing heavier than a cup of tea. After 6 weeks you will be aiming to regain your full range of movement and begin light strengthening exercises. There will be no heavy lifting for the first 3 months.
You can return to office based work after the first few weeks once comfortable, but driving is not advised until after 6 weeks and manual work not before 3 months.
