Distal Bicep Tear
- Description / Cause
- Typically an acute cause of large eccentric load
- Disconnections of bicep from radial tuberosity
- Prevalence / Risk factors
- Complete bicep tendon tear is the most common
- 1.2 / 100,000 patients per year
- Occur in dominate arm
- Occur more in men 40-50 years old
- Risk Factors
- Smoking (7.5x greater)
- Anabolic steroid use
- Previous distal bicep rupture ipsilateral
- Contralateral bicep rupture
- Signs / Symptoms
- Visible deformities of retracted biceps
- Pop sound during injuries
- Sharp pain followed by dull aches
- Weakness in elbow flexion and supination
- Ecchymosis is present acutely
- Void in the antecubital fossa with palpations
- Objective / Special Test
- Imaging – MRI
- Elbow flexion text
- MMT
- AROM and PROM
- VAS
- Treatment / Interventions
- Surgical repair of tendon
- Need for complete tears
- Brace worn to prevent elbow extension past 90 degree until day 10
- PT goals of full PROM in flexion and extension by 6 weeks post-op
- Strengthening exercises may begin after 6 weeks
- Non-surgical treatments
- Can be used for partial tears
- If uses for bicep tendon rupture – significant weakness in elbow flexion and supination
References
1. Bisson L, Moyer M, Lanighan K, Marzo J. Complications associated with repair of a distal biceps rupture using the modified two-incision technique. J Shoulder Elbow Surg. 2008;17(1):67S-71S.
2. Green JB, Skaife TL, Leslie BM. Bilateral distal biceps tendon ruptures. J Hand Surg Am. 2012;37(1):120-123.
3. Taylor S., Hannafin J. Evaluation and Management of Elbow Tendinopathy. Sports Health: A Multidisciplinary Approach September/October 2012 vol. 4 no. 5 384-39.
2. Green JB, Skaife TL, Leslie BM. Bilateral distal biceps tendon ruptures. J Hand Surg Am. 2012;37(1):120-123.
3. Taylor S., Hannafin J. Evaluation and Management of Elbow Tendinopathy. Sports Health: A Multidisciplinary Approach September/October 2012 vol. 4 no. 5 384-39.
Acknowledgements:
David Funk, Student Physical Therapist at A.T. Still University
Ethan Hunke, Student Physical Therapist at A.T. Still University
Morgan Johnson, Student Physical Therapist at A.T. Still University
Ed Nheiu, Student Physical Therapist at A.T. Still University
Lindsay Walczak, Student Physical Therapist at A.T. Still University
Last edited: July 13, 2015
David Funk, Student Physical Therapist at A.T. Still University
Ethan Hunke, Student Physical Therapist at A.T. Still University
Morgan Johnson, Student Physical Therapist at A.T. Still University
Ed Nheiu, Student Physical Therapist at A.T. Still University
Lindsay Walczak, Student Physical Therapist at A.T. Still University
Last edited: July 13, 2015