Distal Biceps Tendon Injuries

Dr Marcus Chia - Elbow Surgeon

Learn about distal biceps tendon injury causes and treatment options. Dr Chia uses minimally invasive and advanced techniques to help you heal, recover and improve your motion.

What are distal biceps tendon injuries?

Distal biceps tendon injuries are injuries and tears that occur on the biceps muscle near the elbow.

The biceps muscle has three tendons, which are strips of tissue that attach the muscle to the bone. Two tendons attach the biceps muscle to the shoulder. The other tendon attaches the biceps to the radius bone at the elbow.

Distal biceps tendon injuries include:

  • Tendonitis – tendon inflammation or irritation
  • Tendon tears – a partial or complete tear, also known as a rupture

What causes distal bicep tendon injuries?

Distal biceps tendon tears usually occur due to:

  • an injury, such as falling on your arm
  • lifting a heavy object
  • overuse.

How do I know if I have a distal biceps tendon injury?

The most obvious sign you have a distal biceps tendon tear is a sudden, sharp, painful feeling in the elbow. Sometimes tendons make a popping sound when they tear. Your elbow may feel tender and painful when you flex.

After a few hours, the sharp pain will feel more like a dull ache. This ache can last for several weeks. You may also notice pain when rotating your forearm. While you may still be able to move your arm, your arm may feel weak when you rotate it from a palm-down position to a palm-up position.

You may also notice:

  • bruising near the elbow
  • weakness
  • a change in the appearance of your biceps.

To diagnose your distal biceps tendon injury, Dr Chia will talk to you about your history and how the injury occurred. If there is no obvious cause of the injury, a regular activity may have caused the tendon to wear down over time.

A distal biceps tendon rupture diagnosis can usually be made during a physical examination. However, sometimes an ultrasound scan or magnetic resonance imaging (MRI) scan can help to accurately diagnose the injury.

What are the treatment options for distal biceps tendon injuries?

There are two main treatment options for tendon tears: surgery and non-surgical treatment options.


It’s important to have surgery as soon as possible after the injury, as this gives you the best chance of a healthy recovery. Several weeks after the injury, the tendon begins to scar and surgery becomes more difficult.

After your surgery, you will need a few months to recover as your tendon heals and you regain normal function.

Dr Chia will talk to you about the various procedures involved in re-attaching the tendon to the bone. Complications include re-rupture, infection and nerve injury.

Nonsurgical treatment options

You may opt for a nonsurgical treatment option for your injury if you have health issues that put you at risk of complications. Some people who are older and not active also choose a nonsurgical treatment, as do people with an injury on their non-dominant arm.

The main consequences of nonsurgical treatment are deformity, weakness (particularly when rotating the forearm) and fatigue pain or cramping.

Nonsurgical treatment options include:

  • Rest and limiting movement
  • Pain-relieving medications
  • Physiotherapy and strengthening exercises to help you regain range of motion

Dr Chia will talk to you about the available options and develop a personalised treatment plan, including treatment, rehabilitation and follow-up care. You’ll need to carefully follow your treatment program to give your injury the best chance of healing and avoid further injury.

Any surgical or invasive procedure carries risks. The information provided here is for general educational purposes only. For more information on elbow arthritis or to learn more about elbow arthritis surgery, please contact the office of Dr Marcus Chia, Sydney, Australia, Orthopaedic Shoulder and Elbow Surgeon.

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