Biceps Gone Pop? Distal Biceps Tendon Rupture Repair and Recovery

Elbow Woes: Understanding Distal Biceps Tendon Rupture and its Impact

Injuries to the elbow joint are relatively common, especially in the athletic population. The biceps tendon is one of the structures within the elbow joint that can easily become injured from blunt force trauma or an excessive load on the joint. One possible injury is a distal biceps tendon rupture. A distal biceps tear is characterized as either partial (does not completely sever the tendon) or complete (severs the tendon off the bone). When a tear occurs to this structure, individuals living in the Dallas, Frisco and Fort Worth, Texas communities can depend on the elbow specialists at Texas Sports Medicine to help return them to the game they love as quickly as possible.

From Heavy Lifts to “Popeye Arms”: Unmasking the Signs and Symptoms of a Biceps Tear

The biceps muscle is located in the front portion of the upper arm and runs from the shoulder joint to the elbow joint. The muscle is attached to bones by two groups of tendons.

  • Lower biceps tendon (distal)- Attaches the lower part of the biceps muscle to the elbow
  • Upper biceps tendon (proximal)- Attaches the upper part of the biceps muscle to the shoulder

The distal biceps tendon (the lower tendon) can become injured from blunt force trauma or excessive loading, often leading to a partial or complete tear (rupture). In many cases, a distal biceps tear occurs in middle-aged men during a heavy weight training session or while lifting an extremely heavy object.

Distal biceps tendon ruptures are fairly uncommon, accounting for approximately 3% of all tendon tears.

Partial or Complete Rip? Non-Surgical and Surgical Options for Biceps Tendon Repair

Once the distal biceps tendon tears, symptoms appear immediately. Common symptoms include:

  • Intense pain at the time of injury followed by throbbing and then milder pain
  • A loud ‘pop’ at the time of injury
  • Biceps swelling
  • Biceps bruising
  • Arm weakness
  • Inability to bend elbow joint
  • Muscle ‘bunching’ that changes the upper arm’s normal contour

Sling, Ice, and Rest: Managing Pain and Inflammation from a Distal Biceps Injury


Nonoperative measures are generally reserved for patients with a partial tear and individuals with low demand activities, typically elderly adults.

  • Rest
    • Avoid heavy lifting and overhead activities to limit pain and swelling
  • Sling use
    • A sling may be recommended to provide stability to the elbow joint and prevent unnecessary stress on the torn tendon
  • Medications
    • NSAIDs help reduce pain and swelling
  • Physical therapy
    • Exercises designed to strengthen the surrounding muscles to restore movement


A surgical repair should be performed as soon as possible following the distal biceps tear in order to help eliminate the risk of the tendon and biceps muscle scarring and shortening.

  • Distal biceps repair
    • Surgical technique: A minimally invasive procedure is performed to reconnect the torn tendon to the correct location on the bone. If the tendon has retracted or is scarred, a graft may be necessary to reconstruct the tendon.

Splint, Stitch, Swing Again: Recovery Timeline and Rehabilitation after Surgery

  • Splint for 10-14 days
  • Therapy will begin after the splint is removed
  • Return to normal activities is usually 4-6 months

For additional resources on a distal biceps tendon rupture, please contact the Dallas, Frisco and Fort Worth, Texas area elbow specialists at Texas Sports Medicine.