A bicep tear is typically very painful. Pain is often immediate and sharp, described as a sudden, intense sensation. While initial severe pain may subside, discomfort usually persists.
Understanding Bicep Tears
The biceps is a prominent muscle located on the front of the upper arm, extending between the shoulder and the elbow. It helps bend the elbow, rotate the forearm (supination), and assist with shoulder flexion. This muscle has two tendons connecting it to the shoulder blade (proximal tendons) and one tendon connecting it to the forearm bone near the elbow (distal tendon).
Bicep tears can be partial, where the tendon is damaged but not completely separated, or complete, meaning the tendon has fully detached from the bone. Tears most commonly occur at the shoulder (proximal tears), involving the long head of the biceps tendon, though tears at the elbow (distal tears) are also observed. Injuries often result from sudden, forceful contractions, like lifting a heavy object, or a fall onto an outstretched arm. Overuse and age-related degeneration can weaken the tendons, making them more susceptible to tearing.
Recognizing Other Symptoms
Other signs can indicate a bicep tear. Many report hearing or feeling an audible “pop” or “snap” at the moment of injury. Swelling and bruising are common, often appearing in the upper arm and extending down toward the elbow.
A change in the bicep muscle’s contour may occur. This can manifest as a bulge in the upper arm, sometimes called a “Popeye deformity,” where the muscle shifts closer to the elbow. Conversely, an indentation or gap might be felt or seen near the shoulder or elbow where the tendon has detached. Weakness in the arm, particularly when bending the elbow or rotating the forearm (supination), is a frequent symptom. Difficulty performing tasks requiring hand twisting, like turning a doorknob, can be noticeable.
When to Consult a Doctor
It is advisable to seek prompt medical attention if a bicep tear is suspected. Early diagnosis is important for determining the most effective course of treatment. A medical professional will typically begin with a thorough physical examination, assessing the range of motion, strength, and looking for any visible deformities or tenderness in the arm.
To confirm the diagnosis and evaluate the extent of the injury, imaging tests may be ordered. While X-rays can rule out bone injuries, they do not show soft tissues. Magnetic Resonance Imaging (MRI) scans are often used as they provide detailed images of soft tissues, helping to identify both partial and complete tears. Ultrasound can also be used to visualize the tendon.
Approaches to Pain and Injury
Initial management often involves self-care to reduce pain and swelling. Applying cold packs to the affected area for 20-minute intervals, several times a day, can decrease swelling and discomfort. Resting the arm by avoiding heavy lifting and overhead activities is beneficial, and a sling may be recommended to immobilize the arm.
Over-the-counter pain relievers, such as NSAIDs like ibuprofen or naproxen, can manage pain and reduce inflammation. These medications target inflammation at the injury site. After initial pain and swelling subside, physical therapy often becomes a component of recovery, with exercises aimed at restoring flexibility, movement, and strength.
Treatment options for bicep tears vary based on severity and location. For some partial tears or complete tears in less active individuals, nonsurgical approaches focusing on pain relief and rehabilitation may be sufficient. For complete tears, especially those at the elbow, or for individuals who require full arm strength and function, surgical repair to reattach the tendon may be recommended. Surgical intervention is often more straightforward if performed within a few weeks of injury, as scar tissue can make later repairs challenging.