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Distal Biceps Rupture

A distal biceps rupture occurs when the tendon attaching the biceps muscle to the elbow is torn from the bone. This injury occurs mainly in middle-aged men during heavy work or lifting. A distal biceps rupture is rare compared to ruptures where the top of the biceps connects at the shoulder. Distal biceps ruptures make up only three percent of all biceps tendon ruptures.


Why did I develop a rupture of the distal biceps?

The most common cause of a distal biceps rupture happens when a middle-aged man lifts a box or other heavy item with his elbows bent. Often the load is heavier than expected, or the load may shift unexpectedly during the lift. This forces the elbow to straighten, even though the biceps muscle is working hard to keep the elbow bent. The biceps muscle contracts extra hard to help handle the load. As tension on the muscle and tendon increases, the distal biceps tendon snaps or tears where it connects to the radius.


What does a ruptured distal biceps feel like?

  • Pop in the front of the elbow
  • Immediate intense pain
  • Pain will quickly subside as tension is immediately taken off the pain sensor in the tendon following a rupture.
  • Swelling and bruising in front of the elbow
  • The biceps may have appear to have balled up near the elbow
  • The arm feels weak

The distal biceps tendon sometimes tears only part of the way. When this happens, a pop may not be felt or heard. Instead, the area in front of the elbow may simply be painful, and the arm may feel weak with the same arm movements that are affected in a complete rupture.


Many doctors prefer to treat distal biceps tendon ruptures with surgery. Nonsurgical treatments are usually only used for people who do minimal activities and require minimal arm strength. People who need normal arm strength get best results with surgery to reconnect the tendon right away. Surgery is needed to avoid tendon retraction. When the tendon has been completely ruptured, contraction of the biceps muscle pulls the tendon further up the arm. When the tendon recoils from its original attachment and remains there for a very long time, the surgery becomes more difficult.