Torn Biceps Muscle at the Shoulder
By: Dr. Evangelos Mylonas DC.
Did You Know?
Now that winter is upon us, it isn’t uncommon to see patients in the clinic complaining of shoulder pain after shoveling snow or playing hockey. One of the muscles commonly injured at the shoulder is the biceps. At first it may seem counterintuitive that the biceps is involved in shoulder complaints, but when we look at the anatomy it becomes clear that an injury to the biceps tendon at the shoulder may be accompanied by, or contribute to the development of common shoulder conditions such as shoulder impingement, tendonitis, and rotator cuff injuries.
As the name implies in Latin, the biceps or specifically the biceps brachii, is a “two-headed muscle of the arm” consisting of a long head and a short head. It is located on the front of the upper arm between the shoulder and the elbow and it’s tendons cross both joints. At the shoulder the biceps muscle attaches via two separate tendons. The long head travels across the shoulder joint (the shoulder joint is considered a ball-and-socket joint) and inserts directly into the top of the “socket” area of the joint known as the supraglenoid tubercle. The short head inserts onto a bony prominence on the front of your shoulder blade called the coracoid process. At the elbow the biceps inserts onto the bones of the forearm (ulna and radius) and is firmly anchored there by way of deep fascial connections.
The primary actions of the biceps muscle are to bend your arm (flexion) and turn your forearm outward (supination) at the elbow. It also acts as a shoulder flexor to some degree and helps to stabilize the shoulder joint via its tendinous attachments.
Ninety percent of biceps tears happen at the shoulder as compared to the elbow. Statistically you have a greater chance of straining your biceps if you are older than 40, perform heavy or repetitive overhead activities, are a smoker and use or have used corticosteroid medications. All of these factors contribute to the wearing down and fraying of the biceps tendon slowly over time.
The two most common causes of a biceps tendon strain at the shoulder are:
- Injury or Trauma – falling on an outstretched arm a sudden increased load on the biceps tendon (during heavy lifting at work or during resistance training at the gym) can cause an acute biceps strain.
- Repetitive Strain – gradual wear and tear of the biceps tendon can occur with overuse during work and daily activities and can lead to a biceps tear. Repetitive overhead activities (e.g. swimming, racket sports) place more stress on the biceps tendon and can lead to strains or ruptures, especially if the tendon has been weakened over time.
Symptoms of a torn biceps at the shoulder:
- Sudden sharp pain in the shoulder and upper arm.
- Possible snapping or popping sound.
- Weakness in the shoulder and upper arm.
- A bulge in the upper arm above the elbow
- An Indentation close to the shoulder.
- Bruising from the upper arm to the elbow.
- Difficulty bending the elbow and rotating the palm up.
Strains of the biceps muscle and tendon can be categorized broadly into two groups, partial tears and complete tears. A partial tear will respond well to conservative care (e.g. rest, ice, gentle movement, functional rehabilitative exercises, and soft-tissue therapies) and will usually heal within six to eight weeks. If there is a visible defect in the biceps (a bulge or dent) this can be indicative of a complete tear or rupture and you should consult with your medical doctor. A complete tear needs to be surgically repaired.
If you are suffering from shoulder pain or suspect that you have injured your biceps muscle/tendon, then please feel free to contact us at the clinic. We strive to provide all our patients with a clear and comprehensive understanding about what their condition is and how they can achieve the results they want. We work together with our patients as a team, guiding them throughout the different phases of their care, so that they can recover quickly and pursue whatever activity or sport that they are passionate about. If you would like more information about treating this or other conditions, or would like to book an appointment, just give us a call at the clinic 403 241-3772.