The biceps muscle runs between the shoulder blade and the bone of the forearm, and is involved in bending the arm. A biceps rupture is where the muscle breaks away from one of the bones to which it is attached, often causing pain and a lack of strength when moving the arm. The biceps muscle consists of two parts, known as the long head and the short head, and each of these is attached to the shoulder blade by a strong band of tissue known as a tendon, while lower down the heads merge and are joined by a single tendon to the bone of the forearm. Normally a biceps rupture involves the tendon of the long head ripping away from the shoulder bone and, while the muscle as a whole may still function, it is much weaker. Treatment may involve surgery, or a combination of rest together with a program of muscle-strengthening exercises.
A biceps rupture commonly occurs in a middle-aged person as the result of tendon irritation taking place over a long period. This could be due to the wear and tear involved in making repetitive arm movements, or it could follow arthritis in the shoulder, leading to the development of rough surfaces on the shoulder bone which cause tendon rubbing. Sometimes small outgrowths of bone, known as spurs, develop and chafe against the tendon. When the condition results in what is loosely termed a torn muscle, it is actually the tendon that frays and wears through rather than a muscle tear occurring, and the person may hear a snapping sound accompanied by a sharp pain.
Younger people can experience a similar bicep injury, but this is more likely to be caused by sporting activity, perhaps during a fall, or when weightlifting, where sudden stress is placed on the bicep muscle. Sometimes there are no symptoms of muscle pain, and the only sign of biceps rupture is the presence of a lump in the arm, caused by the detached muscle bunching up. Usually this swelling is seen or felt somewhere between the shoulder and elbow, although in less common ruptures affecting the lower tendon, the lump is more likely to appear near the elbow.
A biceps rupture is typically diagnosed by listening to the patient's story and examining the affected arm. Treatment of the condition depends on the individual doctor, as there is no general agreement regarding whether surgery is more effective than non-surgical methods. Non-surgical options are more commonly used for older patients and involve rest, accompanied by anti-inflammatory medication, and cold packs applied to the injured area. Later, exercises are carried out in order to strengthen the muscle and preserve a full range of movement.