Distal biceps tears are exceedingly common mostly from a sudden contraction of one’s biceps against a moderate to heavyweight. People will feel a pop in the elbow with a noticeable deformity where the biceps retracts towards the shoulder leaving a lump at the biceps and a loss of biceps tissue near the elbow. The muscle pulls the tendon proximally or towards the shoulder and therefore it looks abnormal at the elbow. Injury mechanisms have been seen with people at work lifting a heavy garbage bag and throwing it or lifting heavy appliances and trying to lift it in a Worker’s Compensation situation. In sports, it can occur from a biceps curl or a reverse grip deadlift with the athlete trying to curl the bar accidentally. Most people prefer especially for young active people and laborers to reattach the tendon as it is important in flexion and supination strength. Studies say that approximate 30% of weakness can occur if it is not reattached. People also noticed a pain or cramping sensation in their biceps region if it is not fixed.

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As you can see from the anatomy the muscle becomes a tendon and attaches to the forearm bone called the radius. When the muscle contracts it allows the radius to then rotate or supinate. This motion rotates the palm upwards towards the sky with a flexed elbow or on a right-handed person it is the same motion as trying to screw in a screw while using a screwdriver.

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The surgery is fairly routine exposing the radius and then reattaching the biceps through a number of mechanisms including buttons, drill holes or anchors.

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Rehab is controlled motion for 6 weeks then starting resistance and getting back to full duty work by 4 months or so.

Warning!!!! Graphic photos from surgery below.

Photos show the tendon being identified. The shoulder is to the left and the hand is to the right in the photo of a left arm. Then the anchor is being placed into the bone. Then sutures are passed through the tendon and secured down to the bone.

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