Distal Biceps Tendon Rupture and Tendinitis

What it is

The biceps muscle bends the elbow and turns the palm upward. Its lower tendon attaches to the radius just below the front of the elbow. The tendon can become inflamed (tendinitis), weakened over time (tendinosis), partially torn, or ruptured.

What causes it

Ruptures usually happen without warning when a heavy object, such as furniture, slips and forces the bent elbow straight. Weightlifters are at risk when lowering weights. Ruptures are most common in men over 30, and long-term steroid use, including anabolic steroids, raises the risk. Repeated lifting can cause tendinitis.

Symptoms

• A pop or tearing sensation at the front of the elbow
• Pain, swelling, and bruising
• A bunched-up biceps muscle higher in the arm
• Weakness, especially turning a screwdriver or doorknob

The elbow still works because other muscles help, so ruptures are sometimes mistaken for a strain.

Treatment

A completely torn tendon does not reattach on its own. Seek care promptly: surgical repair is most successful soon after the injury and can become difficult or impossible if too much time passes. An MRI or ultrasound may confirm the tear. Surgery reattaches the tendon to the bone, and after therapy most people return to even heavy activities. Choosing not to have surgery means some permanent weakness and fatigue, mainly when turning the palm up.