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Injury/Pain

The Complete Guide to Torn Biceps

Overview

The biceps, the muscles in the front of the upper arm, extend upward to the shoulder and downward to the elbow. A strained biceps, which is actually a tear in the biceps tendon, is an injury that's being reported more frequently than in the past, but the reason isn't clear.

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And although the tendons can be torn at either end of the muscle, the one that attaches to the shoulder accounts for the vast majority of biceps ruptures, which occurs when the biceps tendon detaches from the bone. It's vulnerable because it goes through the shoulder joint, which is used, and sometimes overused, by athletes in almost every sport.

How Torn Biceps Happens

The tendon near the elbow is strained or torn when an athlete's arm absorbs an unexpected amount of force (e.g. a skier or snowboarder breaking a fall) or during a forceful pushing motion. The impact causes partial or complete tears in the tendon or muscle tissue, which may already be worn or frayed if the person is over 40. When the tear involves the upper part of the biceps at the shoulder, the result is the same, but it’s more likely to be caused by overuse. In older athletes, a biceps tendon rupture might be associated with a tear in one of the four rotator cuff muscles.

Torn Biceps by the Numbers

40-60
The age range of people most likely to sustain a torn biceps muscle.

90
The percent of torn biceps that happen near the shoulder (rather than near the elbow).

Who’s At Risk for Torn Biceps

Weightlifters are at high risk because of the load regularly placed on the biceps. Sustaining a torn biceps while performing curls is a classic example of how the injury occurs. Football players, skiers, gymnasts, tennis players, rowers, boxers, wrestlers, and throwers (javelin, shot, discus) are also at higher-than-normal risk of in. Older athletes are more susceptible than younger athletes, and men are more likely to tear the biceps tendon, but that may reflect the number of participants in a sport rather than a genetic or physiological predisposition. Anyone who has had a previously torn biceps injury is more likely to experience a similar injury.

Symptoms

  • Sudden pain in the upper arm, but less pain with tears at the shoulder than with those close to the elbow
  • Possible snapping sound
  • Loss of strength
  • Tenderness in the shoulder
  • A bulge in the upper arm or a dent close to the shoulder
  • Bruising from the upper arm to the elbow
  • Difficulty when trying to bend the elbow and rotating the forearm outward
  • Muscle spasms

Initial Treatment

  • Apply ice packs for 15-20 minutes, 3-4 times a day for the first 48-72 hours.
  • Moist heat for 15-20, 3-4 times a day after the first 48-72 hours may relieve pain.
  • Avoid any activity that causes shoulder pain or weakness.
  • Aspirin, acetaminophen, ibuprofen, and naproxen may relieve pain.
  • Complete tears require surgery. Partial tears may heal with more conservative treatment.
  • If a visual defect is present, you should see a doctor.

Comeback Strategy

  • For a complete tear in which surgery is needed, return to full sports participation may take 4-6 months. Supervised physical therapy is typically advised.
  • Partial tears usually heal within 3-6 weeks.
  • Resume regular training only when you have normal shoulder and upper arm strength, full range of motion, and no pain.

Incorporate these prehab exercises into your warm-up routine:

  1. Elbow Range of Motion: It's necessary to restore the normal movement of both the elbow and shoulder prior to returning to activity. To increase flexion, or bending, of the elbow, actively bend your elbow as much as you can. Continue to try and bend your elbow as you use your other hand to help give you extra pressure into the movement. To restore extension, or straightening of the elbow, reach your arm out straight and fire your triceps, the muscle located at the back of your arm. Use your other hand to gently grab your wrist, and pull back until you feel a slight stretch on your forearm and front of upper arm.
  2. Tricep Push Downs
  3. Supination/Pronation

How to Treat Torn Biceps

  • Allow for extra warm-up time in cold weather.
  • Don't increase the intensity, duration, or frequency of exercise involving the biceps muscles more than 10 percent a week.
  • Wear sport-specific equipment to protect the arms and shoulders.
  • Get help from a certified strength and conditioning coach to ensure proper lifting technique.

Incorporate these prehab and movement prep exercises into your warm-up routine:

  1. Squeeze-Release (for grip strength): Squeeze and release a stress ball for 2-3 minutes, every other day. Over-doing this exercise can make symptoms worse. Perform the exercise in a manner that doesn't cause pain.
  2. Wrist Rotation (for supination/pronation strength): Hold a light weight in one hand. Turn your palm up to the ceiling, then down to the ground. Repeat on each side, three sets of 10, every other day.
  3. 4-Way Forearm
  4. Tricep Push Downs
  5. Supination/Pronation
  6. Handwalks

Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.


Tags: Injury Prevention, Biceps, Injury, Reduce Pain, Upper Body Pull, Arms

References

  1. Sue Falsone PT, MS, SCS, ATC, CSCS, 
Director of Performance Physical Therapy at Athletes' Performance, Arizona
  2. American Academy of Orthopaedic Surgeons
  3. Complete Guide to Sports Injuries
  4. Sports Science Orthopaedic Clinic
  5. The Sports Medicine Bible

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