Distal Biceps Tendon Ruptures are common among men, middle aged and older. They can happen in women and younger men as well. Smoking leads to a 5x increase in the rate of rupture because smoking decreases the blood supply to the tendon so that it can’t repair itself as between episodes of repetitive use.
Patients typically are lifting or catching a heavy object when they feel a painful pop in the front of their elbow. Bruising typically follows. If you leave it alone and don’t get it repaired there is a permanent loss of 20-30% of elbow flexion strength and 40-50% of supination strength and endurance. Supination means turning your palm up, like when using tools, opening a door, lifting heavy objects, etc.
Most active people want to have their biceps repaired. It’s been done within the first few weeks. After 4-6 weeks it should still be done, but it’s tougher. For both myself and the patient. There’s more scarring, and the biceps muscle has contracted a little. This can make it tougher to regain motion after surgery. Sometimes the biceps tendon resorbs after rupture. If this happens, we may need to use a cadaveric (allograft) tendon, which is a more complicated procedure that heals slower. Therefore, it’s best not to delay and to see an upper extremity specialist within a week or two after the rupture to get evaluated and to get the biceps tendon repaired in a timely fashion.
After surgery, you’re in a sling for four weeks. Therapy is pretty straight-forward and begins after one week. There’s no heavy lifting for 3 months. The vast majority of patients do extremely well following this surgery and are extremely happy. Once the biceps tendon is fully healed, the arm essentially returns to normal.