How Do You Fix a Torn Biceps Tendon?
As a member of the Medical Advisory Board, Dr. Michael K. Shindle treats a torn biceps tendon using minimally invasive techniques such as tenodesis or biceps tenotomy. By using these techniques, he reattaches the injured tendon to the radius bone using suture anchors and may cut the damaged tendon to restore biceps strength.
For more complex cases, Dr. Michael K. Shindle may perform distal biceps tendon repair, depending on the tear’s location and severity. After the surgery, he also provides an effective recovery plan to reduce post-operative pain and swelling. Call us at 855-321-6784 to book your consultation with our orthopedic surgeon in Bayonne.
What Are the Best Treatment Options for a Torn Biceps Tendon?
The best treatment for a torn biceps tendon depends on the tear’s location, severity, and your activity level. For partial biceps tendon tears, our doctor often recommends rest, ice, anti-inflammatory drugs, and a supervised recovery plan to restore arm strength. In contrast, a complete distal biceps tendon tear near the elbow joint often needs prompt surgical intervention to restore strength.
Here are the surgical procedures that Dr. Michael K. Shindle performs in case of distal biceps tendon rupture:
Distal Biceps Tendon Repair
For a complete long head biceps tendon tear near the shoulder, Dr. Michael K. Shindle may perform this surgical treatment to reattach the torn tendon to the radial tuberosity. Depending on the tear pattern and the preferred procedure for restoring the tendon to its attachment site, he uses these surgical approaches:
- Single-incision technique: In this technique, he makes one cut near the elbow and secures the tendon back to the radius bone using a cortical button or anchor.
- Double-incision technique: During this procedure, he makes two smaller cuts to guide the tendon back to its natural attachment site. He prefers this double incision for more anatomical repair and to reduce certain nerve-related risks.
These surgical reattachments restore elbow flexion and forearm rotation strength, especially in active patients who need strong arm function for work, sport, or daily activities.
Biceps Tenodesis
For a biceps tendon tear or severe tendon damage near the shoulder, Dr. Michael K. Shindle may perform biceps tenodesis. During the biceps tenodesis procedure, the damaged portion of the biceps tendon is released from its painful attachment point and secured to the upper arm bone. This helps reduce pain, improve shoulder function, and strengthen your bicep muscles.
Biceps Tenotomy
In selected cases, Dr. Michael K. Shindle performs biceps tenotomy. It is a shorter surgical repair in which the damaged biceps tendon is released from the shoulder joint rather than reattached. He recommends this option for patients with severe tendon degeneration. In this surgery, recovery is often quick, though some patients may notice cosmetic “Popeye muscle” bulging or mild cramping.
Arthroscopic Shoulder Surgery
According to a study by Dr. Michael K. Shindle et al., full-thickness supraspinatus tendon tears are associated with greater synovial inflammation, tissue degeneration, vascular changes, and collagen organization than partial-thickness tears. These findings suggest that inflammation may play an important role in the progression of rotator cuff disease.
Therefore, when a biceps tendon rupture occurs with other shoulder problems, such as rotator cuff injuries, labral damage, or inflammation, Dr. Michael K. Shindle uses arthroscopic shoulder surgery to treat the underlying damage. He uses small incisions and a camera-guided approach to examine the shoulder joint and remove inflamed tissue.
After surgery, he recommends wearing a sling for 4–6 weeks to support the repaired biceps tendon and promote healing. Additionally, he recommends starting with gentle range-of-motion exercises, then gradually moving towards resistance training.
What Are the Warning Signs of a Ruptured Tendon?
A ruptured tendon often causes a sudden, sharp pain, rapid swelling, bruising, weakness, and difficulty carrying weight on the affected arm. Most patients notice a visible arm deformity or weakness immediately after injury and require urgent medical assessment.
Other warning signs include tenderness around the injury, muscle cramping, and worsening pain when using the affected arm. In some cases, bruising spreads over the surrounding area within hours or days. A complete rupture may also create a gap beneath the skin where the tendon has torn. If left untreated, these injuries can worsen and may lead to long-term weakness, persistent stiffness, ongoing pain, and reduced joint stability. Therefore, our healthcare professionals perform a detailed physical examination. This may include assessing the affected area for swelling, tenderness, bruising, muscle strength, and joint stability. Besides this, we also review our patients’ medical history by asking the following questions:
- How did the injury happen?
- Was there a popping or snapping sensation?
- The level and location of pain
- Is there difficulty lifting, bending, gripping, or rotating the arm?
- Has arm strength reduced since the injury?
Additionally, we may recommend imaging tests, such as an ultrasound or MRI scan, to identify the location, size, and severity of the tear, as well as abnormal bone growth. Based on the imaging results, we will create a personalized treatment plan. This may include exercise programs and nonsteroidal anti-inflammatory drugs to reduce pain and swelling. Reach out today for an appropriate diagnosis and prevent further injury.
What Types of Damage Can Occur in the Biceps?
Biceps damage can include muscle strains, partial or complete tendon tears, tendinitis, bruising, and shoulder impingement. These injuries often cause weakness, swelling, sharp pain, reduced arm movement, or a visible bulge in the upper arm when the tendon or muscle fibers are severely damaged.
Although mild injuries involve overstretched muscle fibers, serious cases may involve tendon rupture, in which the biceps tendon pulls away from the forearm bone. Sometimes damage may involve different parts of the biceps and cause the following injuries:
Proximal Biceps Tendon Injuries
Proximal biceps tendon rupture occurs near the shoulder and commonly affects the long head of the biceps tendon. They may develop from overuse, degeneration, repetitive overhead activity, or a sudden traumatic movement. Moreover, a shoulder-side tear can cause pain and weakness, especially when rotating the forearm from palm-down to palm-up.
In some cases, the most affected patient may develop a “Popeye” deformity, in which the biceps muscle bulges in the upper arm. A PubMed study on proximal long head biceps rupture also found that such acute ruptures are often associated with pathology of adjacent shoulder tendons, particularly the supraspinatus and subscapularis.
Distal Biceps Injuries
These injuries occur near the elbow and are less common, but they can cause greater weakness than shoulder-side tears. They often occur after sudden force, such as lifting heavy objects, rapid pulling movements, sports injuries, or falls. According to the research of Dr. Michael K. Shindle et al., distal biceps tendon rupture is also caused by eccentric loading of the elbow, often in middle-aged males. This can make bending the elbow or turning the palm upward difficult.
Do Bicep Tendon Tears Heal Without Surgery?
Yes, some bicep tendon tears can heal with nonsurgical treatment, especially partial ruptures or tears near the shoulder. However, complete tears near the elbow often need surgery to reduce elbow pain and restore normal function.
For instance, non-surgical recovery is more common with proximal biceps tendon tears, which occur near the shoulder. In such cases, the biceps has more than one attachment around the shoulder, which is treated with Platelet-rich plasma (PRP) injections to stimulate healing of damaged soft tissue. Many patients can regain strength with rest, targeted exercises, anti-inflammatory treatment, activity modification, and guided rehabilitation. But some people may continue to experience cramping, cosmetic deformity, weakness, or pain, especially during lifting or repetitive arm use.
When Should You Consider Surgery?
You should consider surgery for a bicep tendon tear when pain, weakness, or loss of arm function continues despite rest and medication. Our shoulder surgeon also recommends surgery for athletes, manual workers, and those with complete distal tears.
Moreover, we may recommend surgical repair if the bicep tendon tear causes a visible deformity or recurrent cramping. These tears can significantly affect elbow flexion and forearm supination, which are essential for lifting, pulling, twisting, and manual work. In fact, the PMC review found that surgical treatment for distal biceps tendon detachment improved flexion and supination strength. However, we recommend that you get surgical repair within 1 to 3 weeks of the injury to prevent the tendon from retracting (pulling back) and scarring.
What Happens If a Biceps Tear Is Left Untreated?
If a distal biceps tear is left untreated, it results in a permanent reduction in arm strength, chronic pain, muscle cramping, and a “Popeye” deformity where the muscle retracts. Although basic daily arm movements are normal, activities involving lifting, pulling, and twisting the forearm can become difficult.
Over time, the torn tendon can retract farther from the bone. According to a NIH review, distal biceps rupture was associated with 35% lower elbow flexion peak torque and 46% lower supination peak torque in the involved limb. This makes bicep tear repair more complicated and may cause weakness in elbow bending.
In contrast, if a proximal biceps tear is left untreated, it won’t cause serious complications, because the shoulder has two tendon attachments, and one may still function. Moreover, many proximal long-head biceps ruptures are treated conservatively, especially in older or less active patients. However, untreated proximal tears may still cause aching, fatigue, cramping, and reduced strength during repeated overhead or lifting activities. In fact, an NCBI study reported that a 70-year-old man with proximal long-head biceps rupture had a visible Popeye deformity, pain, and weakness during forearm rotation.
How Long Do Tendon Tears Take to Heal?
Partial tears may take 6 to 8 weeks to heal, though return to normal body function may take longer. However, surgical repairs for moderate tears may take 3 to 6 months to heal, with full structural remodeling lasting up to 12 months. Similarly, complete ruptures take 6 to 12 months, or sometimes up to 2 years, for full recovery.
Additionally, tendon repair is a slow process that occurs in three main phases:
Inflammatory Phase (0–7 days)
This is the body’s immediate response to tendon injury. During this stage, blood flow to the injured area increases, and white blood cells move into the damaged tissue to remove dead cells, debris, and harmful substances. This immune response often causes swelling, warmth, redness, tenderness, and pain around the injured tendon. Although these symptoms can be uncomfortable, inflammation is an essential early step because it prepares the area for healing. It also signals the body to begin repairing the damaged tissue.
Proliferative Phase (1–6 weeks)
In this phase, the body begins rebuilding the damaged tendon. During this phase, specialized repair cells produce new collagen fibers that act as a temporary framework to bridge the tear and reconnect the injured tissue. However, the collagen formed during this stage is usually disorganized and immature, making the tendon weak and vulnerable to reinjury. Since the new tissue has not yet reached full strength, heavy lifting or sudden movements during this period can also delay recovery.
Remodeling Phase (6 weeks–6+ months)
During the remodeling phase, the newly formed collagen gradually becomes more organized and stronger. As the tendon is exposed to controlled stress and movement, the collagen fibers begin to align along the direction of force, helping the tissue adapt to normal function. Over time, the tendon becomes denser, more mature, and able to tolerate load. This phase can last several months, which is why tendon injuries often require a gradual rehabilitation process even after pain has reduced.
What Factors Affect the Recovery of the Bicep Tendon?
Recovery of the bicep tendon depends on injury severity, tendon location, treatment type, age, general health, blood flow, and adherence to rehabilitation. Smoking, diabetes, poor nutrition, and early overuse can also delay tendon recovery and increase the risk of re-injury.
Here’s how these factors affect your bicep tendon recovery:
1. Injury Severity
Recovery is usually faster with a mild strain or partial irritation than with a partial or complete tendon tear. This is because mild injuries often involve limited fiber damage, less inflammation, and better preservation of tendon strength. It also allows the tissue to respond more quickly to rest, targeted exercises, and gradual loading.
In contrast, more severe injuries usually take longer to heal because a larger portion of the tendon fibers may be damaged. Therefore, it may require surgical repair or a much longer period of immobilization to restore arm muscle strength.
2. Treatment Type
Recovery depends on the treatment, which may include rest and targeted exercises, injections, immobilization, or surgery. Non-surgical treatment may be suitable for some partial tears or lower-demand patients. However, complete distal tears often need shoulder surgery to regain strength. In some cases, surgery also requires a structured rehabilitation period, which may prolong recovery.
3. Age
Younger people often heal and regain strength more quickly. It is because tissue quality, muscle mass, and general recovery capacity are usually better in them. In contrast, older adults may recover more slowly due to reduced tendon elasticity and slower tissue repair. They may also be at higher risk of associated shoulder or elbow degeneration. According to PMC research, distal biceps tendon rupture is reported most often in active men in the fourth to sixth decades of life.
4. General Health
A person’s overall health supports tendon healing. Therefore, conditions that affect circulation, inflammation, immune function, or tissue repair can slow recovery. For example, diabetes may impair healing and increase the risk of stiffness or delayed recovery, especially after surgery.
5. Blood Flow
Tendons naturally have a limited blood supply compared with muscles, which slows healing. As a result, some parts of the biceps tendon, especially around the shoulder, may have reduced blood flow or degenerative changes. This can delay repair and prolong symptoms.
6. Adherence to Rehabilitation
Rehabilitation usually progresses from protection and gentle range-of-motion work to strengthening and then returns to heavier activity. However, doing less exercise may lead to stiffness and weakness. Similarly, doing too much exercise in the early stages of recovery can strain the repair or re-injure the tendon.
7. Smoking
Smoking can delay tendon recovery because it reduces oxygen delivery, affects blood flow, and interferes with tissue repair. This may slow healing and increase the risk of complications after injury or surgery.
8. Poor nutrition
Tendon healing needs enough protein, calories, vitamins, and minerals. Therefore, in cases of low protein intake, vitamin deficiencies, dehydration, or poor overall diet, collagen repair can be slowed and muscle recovery reduced. In fact, a Science Direct study reports that protein, amino acids, vitamin C, vitamin D, zinc, copper, manganese, and other nutrients may support tendon growth and healing.
How Can You Prevent Future Biceps Injuries?
You can prevent future biceps injuries by warming up properly before exercise and by strengthening your biceps, shoulders, rotator cuff, and upper back. You should also use proper lifting technique and gradually increase your training load. In addition, you should balance pushing and pulling exercises to keep the shoulder joint stable.
Besides this, alternate between different exercises to prevent overuse injuries. For example, alternate between barbell curls and hammer curls to reduce stress on the long head of the bicep. To prevent tears, you should avoid using momentum, such as swinging the body during bicep curls, as this can cause sudden jerking.
If You Need Biceps Tendon Tear Treatment in Bayonne, Consult Our Shoulder Specialist Today!
A torn biceps tendon can quickly make everyday movement painful and frustrating. You may feel sharp elbow pain, weakness when lifting, bruising, swelling, cramping, or a noticeable bulge in your upper arm. You might also struggle to rotate your forearm, carry groceries, exercise, or return to work comfortably.
At Total Orthopedics and Sports Medicine, Dr. Michael K. Shindle performs advanced procedures, such as biceps tenodesis and shoulder arthroscopy, to treat complex bicep tears. Our team also offers easy online bill payment, referral management, medical record requests, and clear surgical instructions to make your treatment more convenient. Visit us at 16 E 29th St, Bayonne, NJ 07002, or call 855-321-6784 to get expert orthopedic treatment.
FAQs
Can I Use My Arm With A Torn Biceps Tendon?
Yes, you may still move your arm, especially with a tear near the shoulder. It is because the second biceps tendon often remains attached. However, you should avoid lifting, pulling, or forceful rotation until a doctor evaluates it. These activities can worsen pain, weakness, or related shoulder damage.
Are Tendon Tears More Common In Certain Age Groups?
Yes, Biceps tendon tears occur more often in older adults because long-term strain can weaken the tendon. Moreover, repetitive overhead activity, weightlifting, smoking, and corticosteroid use further increase the risk of tears. This mostly occurs when the tendon is already degenerated or has tendinosis.
How Soon Should You See A Doctor After A Suspected Tear?
You should see a doctor promptly after a suspected biceps tendon tear, especially if you felt a pop, developed bruising, noticed a bulge, or lost strength. Early evaluation in such cases helps identify the tear location and guides treatment to reduce swelling and protect function.
Is Swelling Always Present With A Torn Bicep?
No, swelling may develop, but it does not always accompany a torn biceps tendon. The most common indicators of a torn bicep are sharp pain, bruising, weakness, cramping, or a “Popeye” bulge. However, severe swelling and bruising may indicate complete tears.
What Are The Common Causes Of A Torn Biceps Tendon?
Common causes of bicep tendon tears include lifting something too heavy and falling on an outstretched arm. It may also occur due to forceful straightening or twisting of the elbow and repetitive overuse. In addition, a sudden movement may tear a tendon that has already weakened over time.
