Biceps tendinopathy and biceps tendon rupture

Last updated: April 26, 2022

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Biceps tendinopathy is a degenerative condition most commonly affecting the proximal long head of the biceps tendon near its origin from the glenoid. Early identification and effective treatment of biceps tendinopathy can prevent a proximal biceps rupture from occurring. Biceps tendon ruptures are injuries to the biceps muscle that result in the complete or partial severing of the tendon from the bone. The tendon of the long head is most commonly affected, usually as a result of trivial trauma in patients with a pre-existing, degenerative joint condition, (e.g., biceps tendinopathy). The rupture is rarely painful and usually does not cause any significant loss of function. By contrast, a tear involving the insertion of the biceps is most often the result of trauma due to overloading, is acutely painful, and entails a loss of movement in the elbow joint. Ultrasound and MRI are used to confirm the diagnosis. Tendinopathy or rupture involving the long head may be managed conservatively with rest and analgesics, while biceps insertion rupture requires immediate surgical repair to restore functionality.

  • Based on location of the rupture
  • Based on extent of the rupture
    • Partial rupture
    • Complete rupture

References:[1]

As mentioned in etiology, distal biceps tears are primarily traumatic whereas underlying degenerative disease (e.g., biceps tendinopathy) can lead to proximal tears.

References:[1]

Diagnosis is primarily clinical. Imaging modalities are used to confirm the diagnosis and determine the extent and location of the rupture.

Surgical repair should be carried out within 2–3 weeks of rupture. After this period, fibrosis leads to muscle shortening, making it impossible to approximate and attach the separated ends.


References:[1]

  1. Virk MS, Cole BJ. Proximal biceps tendon and rotator cuff tears. Clin Sports Med. 2016 . doi: 10.1016/j.csm.2015.08.010 . | Open in Read by QxMD
  2. Churgay CA. Diagnosis and treatment of biceps tendinitis and tendinosis.. Am Fam Physician. 2009; 80 (5): p.470-6.
  3. Esenkaya I, Unay K. Tendon, tendon healing, hyperlipidemia and statins. Muscles Ligaments Tendons J. 2011; 1 (4): p.169-171.
  4. Biceps Tendon Tear at the Shoulder. http://orthoinfo.aaos.org/topic.cfm?topic=a00031. Updated: December 1, 2013. Accessed: February 23, 2017.
  5. Biceps Tendon Tear at the Elbow. http://orthoinfo.aaos.org/topic.cfm?topic=a00376. Updated: February 1, 2016. Accessed: February 23, 2017.

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