Distal Biceps Rupture

What is a Distal Biceps Rupture?

A distal biceps rupture occurs when the tendon attaching the biceps muscle to the forearm (radius) tears. This can happen due to sudden forceful extension against a contracted biceps.

• Leads to weakness in forearm supination and elbow flexion
• More common in middle-aged males

Overview of the Condition

Distal biceps tendon ruptures often present with a visible deformity near the front of the elbow, pain, and a pop at the time of injury. Timely surgical repair is crucial for regaining strength.

Symptoms

• Sudden, sharp pain at the front of the elbow
• Bruising and swelling around the elbow
• Weakness in elbow flexion and forearm rotation (supination)

Causes

A forceful extension against a flexed elbow (e.g., lifting heavy objects) can rupture the tendon. Pre-existing tendon degeneration or steroid use may increase risk.

Diagnosis

A clinical exam reveals a gap or abnormal contour near the elbow crease. MRI may confirm partial vs. complete tear and tendon retraction distance.

Treatment Options

• Surgical repair is typically advised for active individuals
• Non-surgical treatment for low-demand patients, with some strength loss
• Rehabilitation to restore motion and strength

Conservative Management

Non-surgical management may be chosen if the patient tolerates decreased strength. Bracing and physical therapy can optimize remaining function.

Rehabilitation Exercises

1. Gradual range of motion exercises post-injury
2. Forearm strengthening with progressive resistance
3. Functional training to compensate for reduced biceps strength

When is Surgery Needed?

Most complete ruptures in physically active individuals warrant surgical repair within a few weeks of injury to prevent tendon retraction and difficulty in reattachment.

Surgical Procedures

• Single-incision or two-incision technique to reattach tendon
• Sutures, anchors, or buttons to secure tendon to radial tuberosity
• Post-operative immobilization followed by rehabilitation

Anatomy Overview

The biceps muscle has two heads merging into a single distal tendon that attaches to the radial tuberosity. This attachment is key for supination and flexion strength.

Affected Areas

• Distal biceps tendon near elbow
• Radial tuberosity insertion site
• Musculocutaneous nerve region for biceps function

Frequently Asked Questions

QuestionAnswerCan I still lift weights after a distal biceps rupture?Yes, with proper repair and rehabilitation, many return to weightlifting, though full strength recovery can take several months.What happens if I delay surgery?Delayed repair can lead to tendon retraction and scarring, making surgery more difficult and potentially reducing optimal outcomes.

Prevention Strategies

• Avoid sudden heavy lifting with a supinated grip
• Strengthen supporting muscles around the elbow
• Warm up adequately before strenuous activities

Related Conditions

• Proximal biceps tendon tears
• Rotator cuff injuries
• Elbow ligament sprains

Additional Treatments

Platelet-rich plasma (PRP) injections are occasionally considered to promote healing, but the mainstay of complete rupture treatment is surgical reattachment.