A distal biceps tendon rupture is a traumatic injury to the elbow. It can be a source of tremendous pain shortly after the injury occurs. If you suffer this injury, you might even need surgery.

In this article, I answer some of the common questions patients have about these injuries.

What is the distal biceps?

The biceps is the muscle in the arm that helps to flex the elbow and supinate the forearm. It has tendons at the shoulder and at the elbow to attach to bone. A distal biceps tendon rupture is a rupture of the biceps tendon as it crosses the elbow.

What types of people are at risk for distal biceps tendon ruptures?

Athletes in their thirties who play contact or collision sports like football or lift weights frequently tear their biceps tendons. People in their fifties can also suffer these injuries as well.

Also read:
Serious injuries from lifting weights and tips to prevent them

How do distal biceps tendon ruptures occur?

The injury involves a rapid force on the tendon as it is contracting. For example, you might carry a heavy box or piece of furniture. You try to grab it as it falls to the ground. The sudden extension of your elbow can rupture the tendon. Athletes performing biceps curl exercises can suffer these injuries in similar fashions.

How can the doctor know that I injured my biceps tendon?

The orthopedic surgeon can often determine you tore your distal biceps just by asking questions about the nature of your injury and examining your arm. You likely will have a tearing sensation in the front of your elbow. You will notice swelling and bruising that develop quickly. You usually have a bulge of the biceps muscle in the arm. Orthopedic surgeons call this appearance a Popeye deformity. Normally you can feel the tendon of the distal biceps crossing the front of your elbow. After an injury, the distal biceps tendon becomes difficult to identify. MRI can reveal the injury if the diagnosis is uncertain.

Popeye deformity from a distal biceps tendon rupture
Note the bruising around the elbow as well as the prominence of the biceps muscle (“Popeye” deformity).

Do I need surgery for a distal biceps tendon rupture?

Older, less active people often do well without surgery. The cosmetic deformity often persists, but you might have few limitations. You could have weakness with supination of the forearm, such as turning a screwdriver or doorknob.

What does surgery to repair the distal biceps tendon involve?

A younger, more active patient often chooses to undergo surgery to regain full strength and function. The orthopedic surgeon makes an incision
on the front of the elbow. He then reattaches the tendon to its bony attachment in the forearm. The ruptured tendon can retract further up the arm in the weeks after injury, so most orthopedic surgeons try to perform surgery within 10 to 14 days of injury.

What can I expect for my recovery from surgery?

The surgery is a fairly short outpatient procedure. Full recovery, though, can take months. The surgeon often limits your elbow motion somewhat to protect the healing tendon. Gradually you can increase your elbow range of motion and strength. Return to full strength and activities often takes four or more months.

If you suffer an elbow injury and have the tearing sensation, the bruising of the arm and the bulging muscle, you should seek evaluation by an orthopedic surgeon within the first few days. Nonoperative treatment might be appropriate for an older, less active patient. Surgical repair might be better if you are more active. See an orthopedic surgeon, and discuss the treatment option that is best for you.

Distal biceps tendon rupture surgery
A clamp is attached to the distal biceps tendon, which has pulled off the bone in the forearm.

I want to help you! Please take a few seconds to share the biggest challenge or struggle you’re facing with your injury! Click here!

Recommended Products and Resources
Click here to go to Dr. David Geier’s Amazon Influencer store!
Due to a large number of questions I have received over the years asking about products for health, injuries, performance, and other areas of sports, exercise, work and life, I have created an Amazon Influencer page. While this information and these products are not intended to treat any specific injury or illness you have, they are products I use personally, have used or have tried, or I have recommended to others. THE SITE MAY OFFER HEALTH, FITNESS, NUTRITIONAL AND OTHER SUCH INFORMATION, BUT SUCH INFORMATION IS DESIGNED FOR EDUCATIONAL AND INFORMATIONAL PURPOSES ONLY. THE CONTENT DOES NOT AND IS NOT INTENDED TO CONVEY MEDICAL ADVICE AND DOES NOT CONSTITUTE THE PRACTICE OF MEDICINE. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. THE SITE IS NOT RESPONSIBLE FOR ANY ACTIONS OR INACTION ON A USER’S PART BASED ON THE INFORMATION THAT IS PRESENTED ON THE SITE. Please note that as an Amazon Associate I earn from qualifying purchases.