The biceps brachii muscle can rupture either as a consequence of direct trauma or secondary to overuse. Often in the case of overuse, the tendon involved may already exhibit characteristics of a tendinopathy/tendinosis. To complicate matters further, this already weakened tendon may not necessarily be symptomatic prior to the development of a tear.
In this case, the person will feel sudden pain, a pop, bruising and swelling. It may also be possible to feel or see a lump in the lower biceps muscle (“Popeye” sign). This is because, as the tendon tears in the upper part of the arm, the pull of the biceps tendon at the insertion of the muscle onto the elbow results in the muscle bunching up close to the elbow, producing this characteristic “Popeye” sign. The shoulder pain from a biceps rupture is sometimes completely relieved after the rupture occurs and, surprisingly, a rupture only causes approximately 25 percent decrease in muscle strength, see:
Conservative management is usually considered appropriate for middle-aged or older patients and for those who do not require a high degree of supination strength in daily activities. Often, rest is recommended, followed closely by a range of motion and strengthening exercises for the shoulder and elbow.
The surgical intervention of choice is tenodesis and subacromial decompression proximally (or anatomic reattachment distally) for young or athletic patients. A tenodesis is an intervention which consists of cutting the normal attachment of the biceps tendon on the shoulder socket and reattaching the tendon to the arm bone (humerus).
(The list of conditions given above and subsequent explanations are intended as a general guide and should not be considered a replacement for a full medical examination. Furthermore, we do not purport to treat all the conditions listed. Should you wish to discuss any of these conditions with our chiropractors, please do not hesitate to phone the clinic on 020 7374 2272 or email firstname.lastname@example.org).