Proximal Biceps Tendon Tear or Rupture (at Shoulder)

A proximal biceps tendon tear occurs when the tendon that connects the biceps muscle to the shoulder joint becomes partially or completely torn. This injury can cause pain, weakness, and visible changes in the arm’s appearance. The biceps muscle, located at the front of the upper arm, is attached to the shoulder by two tendons: the long head of the biceps tendon and the short head of the biceps tendon. A proximal tear typically affects the long head, while the short head remains intact, allowing some continued arm function.

For information on the distal biceps tendon, click here.

Causes

A proximal biceps tendon rupture often results from injury or degeneration over time. Common causes include:

Acute Injury – A sudden fall, heavy lifting, or forceful pulling motion can cause the tendon to tear.
Repetitive Overuse – Continuous overhead motions in sports (e.g., tennis, swimming, weightlifting) or physical work (e.g., carpentry, painting) can weaken the tendon.
Age-Related Wear and Tear – As people age, tendons naturally lose elasticity and strength, making them more prone to tearing.
Shoulder Conditions – Rotator cuff injuries, shoulder impingement, or chronic tendonitis may increase the risk of a proximal biceps tendon tear.

Signs and Symptoms

Individuals with a biceps tendon rupture may experience:

Sharp pain in the upper arm or shoulder at the time of injury.
A popping or snapping sound when the tendon tears.
Bruising and swelling in the upper arm.
Cramping or weakness when bending the elbow or rotating the forearm.
A visible bulge (Popeye deformity) in the upper arm due to the retracted biceps muscle.

Diagnosis

A diagnosis begins with a clinical evaluation, including:

Medical history and physical examination – Assessing pain, range of motion, and signs of tendon damage.
Strength and movement tests – Evaluating how the biceps muscle and shoulder function.
Imaging tests – X-rays help rule out bone injuries, while MRI or ultrasound scans can confirm the severity of the biceps tendon tear.

Treatment for Proximal Biceps Tendon Tear

The choice of treatment depends on the severity of the proximal biceps tendon rupture, symptoms, and functional needs.

Non-Surgical Management

Most patients will have minimal functional limitations and therefore, in the majority of cases, treatment is non-surgical:

Rest and activity modification to allow healing and reduce strain.
Pain management with anti-inflammatory medications.
Physiotherapy to strengthen surrounding muscles and restore shoulder stability.

Surgical Treatment

In cases of severe weakness, or high functional demands (e.g., athletes, manual labourers), biceps tendon repair surgery may be recommended. Mr Soong Chua is experienced in performing biceps tendon repair procedures, aiming to restore strength and function through minimally invasive techniques.

Proximal (Long Head) Biceps Repair

Book a Consultation

If you’re experiencing shoulder pain, weakness, or a suspected biceps tendon tear, book a consultation with Mr Soong Chua, a highly experienced orthopaedic surgeon in Melbourne. He specialises in minimally invasive shoulder surgery to help restore function and relieve pain.

Frequently Asked Questions

1. What is the best treatment for a proximal biceps tendon tear?

The best treatment depends on the severity of the symptoms and functional impairment. The initial symptoms will settle with rest, physiotherapy, and pain management. Most patients will not require surgery as the functional problems are usually very minimal.

2. How do I know if I need surgery for a biceps tendon tear?

Surgery is usually recommended if you experience persistent pain, significant weakness, or difficulty performing daily activities. Active individuals, athletes, and manual labourers may benefit most from biceps tendon repair surgery.