Overview
The distal biceps tendon attaches the biceps to the radius near the front of the elbow. It can develop gradual load-related pain or tear suddenly under a heavy eccentric load—such as trying to catch a falling object.
Gradual Tendon Pain
Distal biceps tendinopathy often causes deep pain in the elbow crease during pulling or resisted palm-up rotation. Symptoms may improve with temporary load reduction followed by progressive strengthening. Pain here overlaps with the brachialis, joint and nearby nerve structures.
Sudden Tear
A complete tear more often causes:
- A sudden pop or tearing sensation
- Bruising and swelling near the elbow
- A changed biceps contour
- Marked weakness turning the palm upward
- A gap where the tendon normally crosses the elbow crease
A partial tear may be less obvious but still cause persistent pain and weakness.
Treatment
Gradual tendon pain is usually managed without surgery through workload modification and progressive rehabilitation. Complete tears require timely specialist assessment. Surgery is often considered for active people who need to restore supination strength, while nonoperative care may suit selected people depending on age, health, demands and preferences.
When to Get It Assessed
A suspected acute tear should be assessed promptly rather than watched for several weeks because treatment decisions can be time-sensitive.
References
- AAOS OrthoInfo. “Biceps Tendon Tear at the Elbow.” https://orthoinfo.aaos.org/en/diseases--conditions/biceps-tendon-tear-at-the-elbow/
- StatPearls. “Biceps Tendon Rupture.” https://www.ncbi.nlm.nih.gov/books/NBK513235/