Biceps tendon tear at the shoulder

A torn bicep tendon at the shoulder can cause weakness and make it difficult to rotate your arm.

About a shoulder biceps tendon tear

A biceps tendon tear at the shoulder is known as a proximal biceps tendon rupture.

The biceps muscle in your upper arm is attached to your shoulder joint by two strong cords of fibrous tissue called the proximal biceps tendons.

These enable you to bend and rotate your arm, and help to stabilise your shoulder joint.

Proximal biceps tendon tears are most common in men over the age of 60. You can either have a partial or a complete tear.

A tear usually occurs when you are lifting or pulling on a heavy object. It can also be caused by a fall on an outstretched arm.

Partial tears can be the result of overuse, such as repeated throwing action.

Other arm muscles can substitute for the injured tendon, usually resulting in full motion and reasonable function.

Without surgical repair, your injured arm will have a 30% to 40% decrease in strength.

Symptoms of a biceps tendon tear

There is often a 'pop' in the upper arm when the tendon ruptures.

Pain is severe at first, but may subside after a week or two.

Other symptoms include:

  • sudden, sharp pain in your upper arm near your shoulder
  • an audible popping sound at the time of injury
  • pain, tenderness and weakness at the shoulder
  • trouble turning your arm palm up or down
  • a bulge in the upper arm (Popeye sign)
  • bruising to the upper arm

Diagnosis of a biceps tendon tear

You will have a medical examination to assess your range of movement and pain levels, and an MRI scan to view the extent of the injury.

Treatment of a biceps tendon tear

Non-surgical

Non-surgical treatments may be considered if you have a partial tear of the tendon or are inactive and have injured your non-dominant arm.

  • Rest – Avoid heavy lifting and overhead activities. Your doctor may recommend using a sling for a brief time.
  • Anti-inflammatories – Drugs like ibuprofen can reduce pain and swelling.
  • Physiotherapy – After the pain decreases, you can be given exercises to build up the other muscles around your shoulder.

Surgery

If you have a complete tear of the proximal biceps tendon and you are very active, you will normally be advised to have surgery to avoid a significant long-term loss of function.

Most proximal biceps tendon surgery involves drilling holes into the humerus head (the top of your upper arm bone) and fixing the tendon in the holes using stitches.

Another method is to attach the tendon to the bone using small metal implants called suture anchors.

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Published: 6 February 2020 | Review: 6 February 2023

Disclaimer: This information is published by Cromwell Hospital and is based on reputable sources of medical evidence and experience from over 30 years of treating patients. It has been peer reviewed by Cromwell Hospital doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. If you have any feedback on the content of this patient information document please email info@cromwellhospital.com or telephone 020 7460 5901.