Your biceps are muscles that run from each shoulder to just past your elbows. They’re the muscles that bend your arms at the elbow and rotate your upper arms, and you use them countless times each day. The biceps are relied upon for a huge range of activities and, considering the sheer frequency with which you use them, it may come as no surprise that they’re susceptible to injury.
In this blog, NYC orthopedic shoulder surgeon, Dr. Francis Mendoza, will address the common causes of biceps tendon injuries, as well as the symptoms that may indicate that you’ve sustained this type of injury.
What causes biceps tendon injuries?
Each biceps muscle has two “heads.” This is why it’s called the biceps—“bi” means two. Your biceps muscle begins at your shoulder as two separate pieces then merges into a single muscle midway down your upper arm and attaches to your forearm below your elbow. The long head of each biceps attaches to the top of your shoulder socket via a tendon, while the short head attaches to a finger-like protrusion on your shoulder blade called the coracoid process. The other end of each biceps attaches by a tendon to your radius (your larger forearm bone) just below your elbow.
Biceps injuries typically occur where the tendons attach to the bones. The most common types of biceps injuries include:
Tendonitis of the long head of the biceps – This occurs when the tendon becomes irritated and inflamed. This is most often due to overuse. Biceps tendonitis, like other forms of tendonitis, is generally a repetitive strain injury and usually occurs due to repeated overhead motions.
Partial biceps tear – This can occur either at the shoulder or at the elbow. When this happens, the tendon gets torn but doesn’t detach from the bone completely. It can be the result of repetitive use, which causes the tendon to fray – much like an over-used rope – or it can occur suddenly if you lift something too heavy or fall on an outstretched arm.
Complete biceps tear – In a complete biceps tear, the tendon is completely severed or detached from the bone. Like a partial tear, this can be the result of trauma such as a fall, or it can be the final step of prolonged wear and tear in which the tendon finally frays so much that it snaps.
What signs may indicate that you’ve suffered from a biceps tendon injury?
Tears in the tendon of the long head are most common, while tears in the tendon of the short head seldom happen. This means that you may still have the use of half of your biceps even if you have sustained a complete tear. Symptoms vary depending on whether you have tendonitis or a tear, and where the tear has occurred.
Biceps tendonitis symptoms include:
- Pain at the front of your shoulder that usually worsens with activity, especially overhead lifting
- Pain, or an ache that radiates down your upper arm bone
- An intermittent snapping or popping sound in your shoulder when you move it
A tear in a biceps tendon at the shoulder often causes:
- A sudden, intense pain in your upper arm; you may even hear a pop if the tendon tears completely
- Cramps in your biceps if you use it
- Bruising, usually from the middle of your upper arm toward your elbow
- Pain and tenderness at your shoulder, and possibly at your elbow
- Weakness in your shoulder
- Difficulty rotating your upper arm
- You may have a large bulge above your elbow, where the muscle bunches since it’s no longer under tension
Symptoms of a biceps tear at the elbow are similar and include:
- Bruising that begins at the elbow and extends down into the forearm
- Difficulty rotating your forearm
- A large bulge in your upper arm from the retracted muscle
- Swelling at the elbow and weakness when you try to bend it
How is a biceps tendon injury treated?
Some biceps tendon injuries, such as tendonitis, can be effectively treated with conservative therapies such as ice, anti-inflammatory medications, rest, and physical therapy.
In more severe cases, biceps tendon surgery may be necessary in order to maintain normal use of your arm, particularly if you have a tear in the tendon at your elbow. This may involve repairing the damaged portion of the tendon and reattaching it to the bone, either at your shoulder or your elbow. It may also mean removing the damaged portion of the tendon completely, then reattaching it. In rare cases, the tendon of the long biceps head may be too damaged to repair or reattach, and surgery may be a simple case of releasing the tendon completely. Surgery for some types of biceps tendon injuries can be done arthroscopically.
Where can I find treatment for my biceps tendon injury in NYC?
If you’re suffering from any of the telltale signs of a biceps tendon injury, call or schedule an appointment with Dr. Francis Mendoza today. The sooner you get treatment, the better your outcome will be.