The biceps are muscles in the front of the upper arm. They extend downward to the elbow and upward to the shoulder. A bicep tear occurs when the tendon detaches from the bone. You can tear tendons at either end of the muscle, although the tendon that attaches to the shoulder is usually the one that is torn. This tendon is vulnerable because it contains the shoulder joint which can be overused by athletes in all sports. Biceps tendon tears can either be complete or partial. Complete tears split the tendon into two pieces, while partial tears only tear the tendon slightly. Other parts of your shoulder can be damaged when you tear your bicep, including rotator cuff tendons. The following are symptoms of a torn bicep: a snapping sound, tenderness in the shoulder, loss of strength, sudden pain in the upper arm, bruising in the bicep area, a bulge or dent close to the shoulder, muscle spasms, and difficulty rotating the forearm outward or bending the elbow.
The tendon in the bicep can be torn when a person’s arm takes in an unexpected amount of force or during a forceful pushing motion; for example, a snowboarder or skier breaking a fall with their arm. The impact of the fall or trauma can cause a complete or partial tear in the muscle tissue or tendon. It may already be frayed or worn. Tears that involve the upper part of the biceps at the shoulder are generally caused by overuse and overexertion as opposed to impact. Weightlifters are at very high risk because of the amount of weight they place on the biceps regularly. Other athletes at risk are skiers, football players, tennis players, gymnasts, boxers, rowers, and wrestlers. Older athletes are more susceptible to suffering a torn bicep than younger athletes.
For non-athletes, the best way to treat a torn bicep is time. For most people, pain and symptoms from a torn bicep eventually go away, and in some people, mild arm weakness may not affect their daily activities at all. If you have not damaged any other area of the arm or shoulder, non-surgical treatment is the best option. Make sure you rest; avoid lifting heavy equipment or objects, or any activities that require you to lift your arm over your head. Use ice daily; ice for about 20 minutes at a time throughout the day. Make sure the ice pack is wrapped in a towel to avoid damage to the skin, such as frostbite. In some cases, you may have to wear a sling. Athletes who need to completely recover their strength and full function of the arm tend to have surgery right away to repair the tear.
For a complete bicep tear where the athlete needs to undergo surgery, it may take 4-6 months before they are able to return to full sports participation. Tears that are only partial tend to heal within 1-2 months. It is important to only resume regular training and exercising when you return to regular upper arm and shoulder strength, no pain, and a complete range of motion with your shoulder and arm. During rehab, it is important to incorporate exercises that help restore the normal movement of both the shoulder and elbow. Avoid increasing frequency, duration, or intensity of exercises drastically. Instead, increase each by about 10% per week, and stop immediately if you feel any pain or discomfort. Attempting to rehab too fast may make the injury worse, and your recovery time longer. When you do return to play, wear specific equipment to help protect the shoulders and arms. The American Academy of Orthopaedic Surgeons has more information on bicep tears and rehabilitation exercises.