What is a Distal Bicep Tendon Rupture?

A tendon is a type of strong, fibrous tissue that connects a muscle to a bone. The muscle fibers blend into the tendon tissue, which then inserts itself onto the bone.

The distal bicep tendon is the tendon that connects the distal (or lower) portion of the bicep muscle to a bone in the forearm called the radius.

A distal bicep tendon rupture occurs when this tendon is partially or completely torn away from its attachment on the radius.

The distal bicep tendon is vital for elbow flexion (bending) and supination, which rotates the palms from facing down to facing up.

What causes distal bicep tendon rupture?

It is relatively uncommon for the distal portion of the bicep tendon to rupture, accounting for only 10% of bicep tendon ruptures. The other 90% occur where the bicep tendon inserts inside the shoulder.

Some risk factors for rupture are anabolic steroid use and smoking. The injury typically occurs when a rapid force is exerted on the biceps muscle.

How Can I Tell if My Distal Bicep Tendon is Ruptured?

The most accurate way to know if this has occurred is to get assessed at a clinic where we will carefully review your medical history and perform a thorough physical exam.

Here are some signs that we look for:

A pop in the elbow accompanied by a severe pain

Significant bruising over the elbow that may track down the forearm

Considerable reduction in strength

The “reverse Popeye” sign. When the tendon is torn, it causes the muscle belly of the biceps to shorten and contract. This causes a large bulge in the arm where the biceps would typically be, similar to the cartoon Popeye.

We confirm any diagnosis with an MRI.

How Does a Surgeon Repair a Distal Bicep Tendon Rupture?

As with other tendon ruptures that can occur elsewhere in the body, it needs to be repaired surgically.

First, we make an incision over the front of the elbow and retrieve the ruptured tendon. Next, we drill a hole in the bone at the insertion site of the tendon. Finally, the tendon is inserted back into this little trough and held in place with a screw. This allows the body to heal that tendon back in place for return of function.

How Long Does Recovery from a Distal Bicep Tendon Rupture Take?

It usually takes patients 12 weeks before they can start focusing on rebuilding bicep muscle strength. By 4-6 months, most patients have recovered both function and strength.

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