Featured on Channel NewsAsia

Biceps Tendon Rupture


There is acute onset of pain over the anterior part of the shoulder with a lump typically forming at the mid-biceps from the retracted muscle bulk (the ‘Popeye sign’). Usually the biceps longus tendon, originating from the anterior superior labrum, ruptures and the short biceps tendon originating at the coracoid is intact. This leaves some biceps function infact.


This injury often occurs in middleaged or elderly athletes or after cortisone injections. The rupture can be partial, causing pain but no
lump. If complete, the sudden lump on the mid-biceps is typical.


The typical deformation can be seen clearly on resisted elbow flexion. A proximal partial tear or subluxation gives a positive palm-up test.


This is a clinical diagnosis. MRI or ultrasound is usually not required for the diagnosis but may be done to investigate associated injuries.


Usually this injury is treated without surgery with gradual and progressive rehabilitation. Even though the long head of the biceps, subject to sufficient length and quality, can be re-inserted into the humeral head, the functional improvement maybe questionable. However, an associated, SLAP tear is not unusual and may require surgery.


Refer to Dr Kevin Yip (+65 6664 8135) senior orthopaedic surgeon to determine the grade of injury and for consideration of surgery. Refer to physiotherapist to start a three month rehabilitation programme.


Most sports and activities can be maintained, such as cross-training, working-out and running. The specific rehabilitation  should aim at a full range of controlled motion, goodposture and thoraco-scapular control, followed by functional training.


Normal clinical symptoms and signs. The apprehension test should be negative. Functional strength, control and flexibility should be comparable with the other shoulder.


Associated injuries must be ruled out. Due to its origin at the anterior superior labrum, a SLAP tear, with or without impingement, may complicate the situation and require surgery.


Good-Fair, depending on associated injuries.

Leave a Reply

You can use these HTML tags

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>




This site uses Akismet to reduce spam. Learn how your comment data is processed.