What To Know About a Distal Bicep Tear (And What It Feels Like)

If you’re exercising or carrying something heavy and suddenly feel a pop in your elbow, followed by pain and what looks like a deformity in your upper arm, chances are you have a distal biceps tear.

A distal biceps tear (or rupture) is a partial or complete tear of the distal biceps tendon where it attaches to the near end of the radius bone in your forearm. It is a painful injury that typically requires surgical treatment.

Understanding the Anatomy of a Torn Bicep

Most people are familiar with the bicep muscle, which is located in the front of the upper arm. You might not know, though, how the muscle works and supports your arm’s function.

 Black and white close up of person holding elbow with red pain overlay.

Biceps have two tendon connections around the shoulder: one that runs through the shoulder joint and one that connects to the front of the shoulder blade. These connections are known as the proximal connections. At the other end of the humerus (upper arm bone), there is only one connection — the distal connection. This connection attaches the bicep to the forearm at a bump on the radius called the bicipital tuberosity. The radius is one of the two forearm bones. The distal biceps tendon is crucial in maximizing your elbow flexion and rotation strength.

What Causes a Torn Bicep?

Most distal bicep tears are caused by carrying something heavy while your elbow is bent. Weightlifters and furniture movers are particularly prone to this type of injury.

Catching a moderately heavy object while it falls can also cause a torn bicep tendon. This includes grabbing onto something to keep yourself from falling or pulling yourself up. Pulling someone or something toward you rapidly or with great force can also tear the bicep tendon.

Distal bicep tears typically occur in tendons that already have some degree of injury or degeneration, a condition called tendinosis. It is more common in men who smoke or are in poor physical condition. Athletes — and bodybuilders in particular — are also vulnerable.

Symptoms of Distal Biceps Tendon Tear

If you tear the distal biceps tendon, you will know it. You will feel, and maybe even hear, a pop in the front of your elbow and the palm side of your upper forearm. This is typically very painful.

Other signs of a tear include:

  • Swelling around the front of the elbow
  • Bruising on the inner elbow and upper forearm
  • Deformity of the biceps: when the muscle is no longer connected to the elbow, the muscle shortens and gives the appearance that the bicep has migrated up the arm.

Keep in mind that even though the tendon is partially or completely torn, you will still have some function in your arm.

To see what a distal biceps tear injury looks like, check out the video below. WARNING: Some may find this video disturbing. It is a compilation of videos showing athletes tearing their distal biceps tendon during training or competition.

Treating Biceps Tendon Injuries

Seek care as soon as possible if you think you have torn your distal biceps tendon. The injury is not necessarily an emergency, but a prompt response makes treatment more effective and supports faster recovery.

Most orthopedic doctors can confirm a biceps tendon tear by conducting a physical exam. They may order X-rays or an MRI to confirm the diagnosis or rule out any fractures or injuries that could be contributing to your symptoms.

Initial treatment focuses on pain management, usually through over-the-counter pain relievers. After that, surgery is usually required. However, in cases of a partial tear, nonsurgical treatment, such as physical therapy, is an option.

Surgery to Repair a Torn Bicep Tendon

The primary goal of surgery to repair a distal biceps tear is reattaching the end of the torn tendon to the radius bone and holding it in place long enough for the tendon to heal. This can be accomplished in several ways:

  • Sutures in the tendon can be passed through drill holes in the bone and tied
  • Suture anchors and sutures can be used to help adhere the tendon to the bone
  • A screw can secure the tendon in a hole created in the bone

This type of surgery is minimally invasive. Depending on the method used, it only requires one of two incisions. You will likely need to wear an elbow brace during the initial phase of your recovery. Physical therapy is also a key part of rehabilitation.

The Takeaway on Torn Biceps

A distal biceps tear is a common elbow injury in active people. It often occurs while lifting and is associated with an acute pop, pain, swelling, and frequently a concerning deformity. These injuries nearly always require surgery, but fortunately, the postoperative recovery is relatively simple, straightforward, and usually predictable.

For more information about options to address a torn bicep, call Town Center Orthopaedics any time at (571) 250-5660, or request an appointment today.

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