Biceps is a muscle located in the front section of the upper arm, between shoulder and elbow. Its main function is to bend the arm at the elbow and rotate the forearm. Bending the arm alone is usually not enough to cause biceps pain, which is why we will be talking about more serious injuries today.
The muscle, and its tendons, also help stabilize shoulder joint so a tear in this region will usually cause shoulder instability. This injury in the shoulder region is relatively common and simple to treat. In most cases, ice, rest and latter physical therapy is enough to help people regain strength and mobility in the shoulder joint and get rid of biceps pain.
Biceps tendon tear in the elbow is a bit more complicated since the tendon will not grow back to the bone and heal, so the tendon must be surgically repaired.
Biceps Anatomy And Function
The name biceps comes from Latin words bis meaning “double” and caput meaning “head,”1 what this tells us is that the biceps has two heads – long head (marked in red on the image above) and short head (marked in green).
Before we go ahead and start talking about muscle attachments, we will quickly go through the anatomy of the shoulder joint. Shoulder joint is built up of three bones: humerus (long bone in the upper arm), scapula (shoulder blade) and clavicle (collar bone).
This joint is called “socket joint” because the head of the humerus fits into a rounded socked found on the shoulder blade, called glenoid, or glenoid fossa (fossa – latin for hollow area/depression in a bone)2.
Around this socket, as you can see on the image to the left, is a strip of cartilage called glenoid labrum. Since glenoid fossa is quite shallow, this strip of cartilage plays a vital role in keeping the shoulder joint stable.
Now, the upper end of the long head of the biceps attaches to the top of the glenoid, helping to stabilize the joint and the upper head of the short head of the biceps attaches to bony bump on the shoulder blade called processus coracoideus.
As we go towards the elbow, these two heads merge, so biceps attaches to a bone in the forearm called radius with one thick, powerful tendon.
Types Of Tears
Generally, tears can be:
- Partial – here the tendon is not severed completely, and
- Complete – where the tendon is completely severed
It is clear that complete tear is more severe and, unfortunately, this is the more common one. In most cases, the injury will be so severe that the muscle will be entirely detached from radius and move towards shoulder, causing severe biceps pain and pain, along with pain in the entire upper arm area.
Even though other muscles can substitute for biceps function, surgical repair is advised and recommended; patients who refuse surgery will experience loss in strength and limited range of motion in the elbow joint.
Symptoms and Causes Of Biceps Tear In The Elbow
Even if you`ve never seen a complete biceps tendon tear in your life, I`m sure you would be able to recognize some of the most common symptoms since they are pretty self-explanatory:
- Biceps pain
- Swelling and bruising around the elbow
- Weakness in twisting and bending your arm in the elbow joint
- A gap at the front of the elbow accompanied by a bulge in the upper part of the arm created by the shortened biceps muscle3
The most common cause of muscle tear is injury. Injury common occurs when lifting heavy objects without really realizing how much they weigh. Men are usually those who won`t admit that the load they are carrying is too heavy and, while they are carrying it, strain on the muscle intensifies until the tendon eventually gives is and gets detached from the bone completely.
Treatment For Tendon Tear And Biceps Pain
As we already mentioned, surgical treatment is a must for regaining full strength and mobility. There are some individuals though (usually elderly or people with other medical problems), for whom the surgery might pose too much of a risk, so they are treated non-surgically.
This treatment usually implies rest (in the first couple weeks following the injury) and physical therapy.
As for surgical treatment, doctors may use different procedures, but the main goal is to reattach the tendon to the forearm bone. Here is a video animation showing this exact process:
After surgery, the biceps tendon will take around 2-3 months to fully heal which is why it is vital that you reduce your activities and follow your doctor`s instructions. The biceps pain can go away faster, but it depends on the severity of the injury.
- (September 14. 2014.) Biceps, Wiktionary.org . Retrieved from http://en.wiktionary.org/wiki/biceps
- (May 2009.) Biceps Tendon Tear At The Shoulder, Orthoinfo. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00031
- (June 2009.) Biceps Tendon Tear At The Elbow, Orthoinfo. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00376
- Image, Biceps Muscle: “Biceps brachii muscle13” by Anatomography – en:Anatomography (setting page of this image). Licensed under Creative Commons Attribution-Share Alike 2.1-jp via Wikimedia Commons – http://commons.wikimedia.org/wiki/File:Biceps_brachii_muscle13.png#mediaviewer/File:Biceps_brachii_muscle13.png