Biceps Tendon Injuries


by Dr Marcus Chia - Shoulder and Elbow Surgeon
The biceps muscle is located at the upper part of the arm. It has an important function to bend the elbow and rotate the forearm. The upper part of the biceps muscle is attached to the shoulder with two tendons – the long head and short head. The long head tendon passes inside the shoulder joint itself and is therefore susceptible to injury. It can be a common cause of shoulder pain. The lower part of the biceps muscle is attached to the forearm with a single tendon and this can also tear or be the source of pain in the elbow.

These tendons can become weakened and inflamed (biceps tendonitis) over time from chronic overuse or heavy lifting, leading to fraying of the tendon and in some instances a complete tear or rupture. Biceps tendon injuries are also commonly seen in association with arthritis and tears of the rotator cuff muscles around the shoulder, which may allow the biceps tendon to subluxate from its normal groove.

The most obvious symptom associated with a biceps tendon injury will be pain. Some patients hear or feel a ‘pop’ when the tendon tears. Other symptoms include weakness in the shoulder or elbow or a bulge in the arm called a ‘popeye’ deformity.

If it is suspected that you may be suffering from a biceps injury, Dr Chia will perform a physical examination of the shoulder and elbow in addition to xrays. In certain cases an MRI is needed to confirm the injury and rule out any associated damage to the shoulder.

Initially, management will include rest, ice, analgesia and anti-inflammatory medications. A corticosteroid injection may be helpful. Physiotherapy is useful to gain back strength and flexibility lost with the injury.

The need for surgical management of biceps tendon injuries depends on age, activity level, the severity of the injury and the failure of conservative management. Biceps tendon tears at the elbow almost always require surgical repair.

The surgery involves either cutting the tendon within the shoulder joint called a biceps tenotomy or reattaching the tendon outside of the shoulder joint via key-hole (arthroscopic) or mini-open surgery. This procedure has been shown to be highly successful in alleviating the pain associated with biceps pathology while preserving the normal function of the shoulder.
Any surgical or invasive procedure carries risks. The information provided here is for general educational purposes only. For more information on biceps tendonitis or to learn more about arthroscopic biceps tenotomy or biceps tenodesis, please contact the office of Dr Marcus Chia, Sydney, Australia, Orthopaedic Shoulder and Elbow Surgeon.

(02) 8014 4252

Clinic Locations


Dee Why
Peninsula Orthopaedics
Level 1
812 Pittwater Road
Dee Why NSW 2099

Mona Vale
Mona Vale Rooms
Suite 502, 20 Bungan Street
Mona Vale NSW 2103

Wahroonga
Northside Orthopaedics
San Clinic
Level 4, Suite 403
185 Fox Valley Road
Wahroonga NSW 2076

Bella Vista
HSS Orthopaedics
Hospital for Specialist Surgery
Level 1, Suite 1
17-19 Solent Circuit
Norwest Business Park
Bella Vista NSW 2153