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
- Gradual range of motion exercises post-injury
- Forearm strengthening with progressive resistance
- 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
| Question | Answer |
|---|---|
| Can 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