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Biceps Tear Treatment Options

The biceps tendon is attached to the labrum (cartilage) at the top of the shoulder socket. This is called the long head of the biceps tendon. The most common type of injury to the biceps tendon occurs at this long head of the biceps tendon and is often accompanied by a fracture and /or damage to the rotator cuff.

The tendon also attaches to the radius just below the elbow. This is called the distal biceps tendon. The biceps muscle helps you lift your arm, bend your elbow, and rotate your forearm.

A complete tear of the biceps tendon cannot heal itself.  However, surgery is not always required, particularly if the tear is proximal or on the shoulder side.  Conservative treatment for these tears may be adequate to relieve symptoms in most patients. However, conservative treatment can lead to problems with cosmesis and cramping.  Surgery for a shoulder tear is usually reserved for patients wish to not have any of the potential problems listed above.

If the tear is at the elbow, surgery to reattach the tendon to bone may be beneficial to restore function and strength. Sometimes other muscles can perform some of the functions of the distal biceps tendon and conservative treatment may be sufficient. The decision to pursue surgery depends on the patient’s symptoms, needs, goals and preferences.

Surgery may be the best option for patients who desire to return to sports and activities that make life enjoyable, and for those who perform repetitive activities involved in labor and construction, where actions like turning a screwdriver are important.

Partial tears of the distal tendon may initially be treated with conservative management including a period of rest, bracing and activity modification and steroid injections. Tears that involve less than 50% of the tendon can be successfully treated with conservative management. Tears of more than 50% of the tendon are likely to fail conservative management and would benefit from surgical repair. Surgery can restore function and with therapy restore strength. The risk of retearing is low.

A complete tear of distal biceps tendon requires surgery to restore function for patients who need the ability to rotate the palm up for work or sports often choose surgery even when the tear is partial.

A distal biceps repair is where the tendon is reattached to the bone. This surgery should be done in a timely fashion to prevent retraction of the tendon.  Acute repair, within a week or two of the injury is the best option.  A delay in surgical repair can complicate repair surgery, and even cause permanent muscle degeneration (atrophy).

Arthroscopic surgery to repair a complete tear of the biceps tendon is an outpatient procedure, performed with minimal incisions and minimal damage to surrounding structures. Complete healing can require three months of physical therapy but provides restoration of full range of motion and virtually normal strength.

Dr. Patel will discuss your treatment options with you and help you choose the best options for you.

Dr. Ronak M. Patel is a double board-certified orthopaedic surgeon and sports medicine physician trained at Northwestern University and received a fellowship at the Cleveland Clinic. He specializes in the treatment of all knee, shoulder and elbow injuries and degenerative conditions. Contact him to schedule a consultation to learn more about how he can help you return to the life you love and the activities that make life worth living. He serves teens and adults in Chicagoland and NW Indiana.

At a Glance

Ronak M. Patel M.D.

  • Double Board-Certified, Fellowship-Trained Orthopaedic Surgeon
  • Past Team Physician to the Cavaliers (NBA), Browns (NFL) and Guardians (MLB)
  • Published over 49 publications and 10 book chapters
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