What is a Distal Biceps Tendon Tear?
The distal biceps tendon is the main attachment for the biceps muscle onto the radius or bone in the forearm. The distal biceps tendon provides the majority of strength of the elbow in bending (flexion) and twisting the forearm from a palm down to a palm up motion (supination). A distal biceps tear occurs when the tendon is torn off the radius or bone in the forearm.
Mechanism of Injury:
A distal biceps tendon tear is usually caused by an acute traumatic injury in which a quick resistive motion to catch a heavy object occurs. For example, when someone instinctively reaches out to catch a heavy falling object. This can be an acute injury without any previous pain or discomfort. However, this can also be caused by a chronic degenerative issue in which a person has experienced a long time of pain or discomfort due to repetitive motions or heavy lifting.
Symptoms and Diagnosis:
An acute injury usually results in immediate pain and discomfort in the front part of the elbow. In a complete tear, there is a noticeable defect in the front part of the elbow and the biceps muscle can retract or move up the arm causing a defect in normal appearance. This usually only occurs with a complete tear. After a short period of time, bruising is common in the front part of the elbow. Other muscles around the elbow can allow you to continue to move the elbow but does not allow a person to regain the strength of the elbow. Medical evaluation should be sought immediately, as this type of tear is an urgent matter. X-rays should be performed to rule out any other bone injury. Advanced imaging, usually an MRI, is performed acutely to determine the full extent of the issue.
Treatment of a Distal Biceps Tendon Tear:
A complete tear requires urgent surgical management. The most common treatment aims to reattach the biceps tendon to the bone in the forearm (radius). Surgery needs to be performed in a timely fashion or risk atrophy (permanent weakening) of the biceps muscle and prevent reattachment of the biceps tendon if this is delayed for too long of a time. Non-operative or no surgery can be trialed for patients that only have a partial tear.
For more information, please consider the following link that was produced by the AAOS.
https://orthoinfo.aaos.org/en/diseases–conditions/biceps-tendon-tear-at-the-elbow