What Is a Biceps Rupture?

Written by Stephanie Booth
Medically Reviewed by Poonam Sachdev on June 24, 2025
8 min read

A biceps tendon rupture is when you tear one of the strong bands of tissue that connect your upper arm muscle to your shoulder or elbow. This injury can cause sudden pain and make it harder to bend or lift your arm.

Your biceps muscle helps you move your shoulder and bend your elbow. It connects to your bones through three bands called tendons. Two of them — the long head tendon and the short head tendon — attach the muscle to your shoulder. A third tendon near your elbow connects the biceps to a bone in your lower arm, called the radius.

A biceps tendon can tear in one of two places:

  • A proximal biceps tendon rupture happens at the upper end around the shoulder joint.
  • A distal biceps tendon rupture happens near your elbow.

You can have a partial tear, or the tendon can fully break away from the bone. Your treatment will be based on the type of biceps rupture you have.

A biceps rupture can affect your arm’s function in different ways. How much you’re able to move it depends on where the tendon is torn and how serious the tear is. Most ruptures happen in the long head tendon. You might be able to move the arms because other muscles, such as the brachialis (under your biceps) and the supinator (near your elbow), help out. Still, lifting or twisting can be harder.

A ruptured biceps tendon at your elbow is less common but can be more serious. You’ll probably still be able to move your arm, but you may lose strength. For instance, you might not be able to rotate your lower arm from palm-down to palm-up. You might feel weaker when you try to carry objects or hold them tightly.

If you’re an athlete, you’ll often need surgery to regain your full arm strength.

Biceps rupture can happen due to an injury or from overuse over time. .

Distal biceps tendon tears “usually happen because you’re doing something where your arm gets pulled outwards with a lot of force, and it was unexpected,” says Brian Schulz, MD, an orthopedic surgeon at Cedars-Sinai Orthopaedics in Los Angeles. “It’s like something drops and you try to catch it, but it’s heavier than you thought. That’s how these injuries often happen.”

Other common causes of a bicep tendon tear include:

  • Repetitive shoulder movements that strain the tendon
  • Age-related wear and tear that weakens the tendon over time
  • Falling on an outstretched arm
  • A sudden twist of the arm or shoulder

Things that can make one more likely include:

  • Tendinosis, a wear-and-tear condition that weakens the tendon
  • Shoulder problems, such as tendonitis, bursitis, impingement, or a rotator cuff tear
  • Smoking, which reduces blood flow and slows healing
  • Lack of physical activity, which weakens muscles and tendons
  • Corticosteroid use, which can lead to muscle and tendon weakness

Signs of a biceps tendon rupture may include:

  • A popping or snapping sound at the time of injury
  • Pain in your shoulder or elbow (sometimes intense)
  • Weakness in your shoulder, elbow, or arm
  • Bruising on your upper arm
  • Muscle cramps when you use your arm
  • Trouble rotating your arm (such as turning the palm up or down)

You could also see a big bulge in your upper arm. It will look like you have a huge biceps muscle. This is sometimes referred to as a “Popeye muscle” or “Popeye deformity.” It’s more common in proximal ruptures.

A biceps tendon rupture is usually diagnosed with a physical exam. Your doctor will check how you move your arm and test its strength. You might have imaging tests such as an X-ray, ultrasound, or MRI if the tear isn’t clear or is partial.

Your doctor may also do tests to confirm the diagnosis. Two of these include:

Hook test. While you bend and twist your elbow, your doctor will try to hook their finger under the tendon on the outside of your arm. If they can feel it clearly, the tendon is likely intact. But this test may not give accurate results in cases of a partial tear. Nearby tissues can also be mistaken for the tendon.

Biceps squeeze test. Your doctor will support your elbow and gently squeeze your upper arm. If your forearm doesn’t turn outward (a movement called supination), it may be a sign of a torn tendon.

If they confirm the tendon is torn, they may refer you to an orthopedic surgeon. “Within the first three weeks, they’re much easier to fix, and there are fewer complications,” says Schulz. “But if you wait, the tendon can scar, and that makes treatment, especially surgery, more difficult.”

If you treat the tear early, you’ll probably regain full use of your arm. That’s why it’s important to get checked as soon as possible.

 

 

 

Your doctor will choose a treatment based on whether the tendon tore near your shoulder or your elbow, and how serious the tear is.

What nonsurgical treatments can help heal a biceps tear?

If you have a partial tear, your doctor may recommend at-home care such as:

  • Ice or cold packs. These can help reduce swelling when used for 20 minutes at a time.
  • Resting your arm. You’ll need to avoid lifting or big arm movements for a while. A sling may help in some cases.
  • Over-the-counter pain relief. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can ease pain and swelling. Ask your doctor if they’re right for you.
  • Physical therapy. A therapist can guide you through exercises that support healing and strengthen your other arm muscles.

If you’re still in pain, your doctor may inject a numbing medicine and/or corticosteroid in the area of the hurt tendon. They’ll use ultrasound imaging to guide the shot. While this can help make you more comfortable in the short-term, it doesn’t fix your tendon. And it comes with risks such as bleeding and infection.

When is surgery recommended for biceps rupture?

Your doctor is more likely to suggest surgery if you have a complete tear.

“A distal tear is not going to heal on its own,” Schulz says. “You’re not going to be able to use that muscle the way that it was designed anymore. That’s why we’re pretty aggressive about fixing them.”

Your doctor may recommend surgery if:

  • Other treatments don’t improve your symptoms.
  • Your biceps muscle keeps cramping.
  • Shoulder pain or weakness makes daily tasks difficult.

There are different ways your doctor can do the surgery. Sometimes, they use small metal anchors or buttons to attach the tendon to the bone.

Minimally invasive (arthroscopic) surgery is often an option. That allows you to avoid a large incision (cut in your skin) or scar. Instead, your doctor will make tiny cuts in your skin and gently insert a small camera (arthroscope). This gives them a clear view of your injured tendon, allowing them to reattach it to the bone.

After surgery, you may need to wear a sling, brace, or cast for a while. But your doctor will soon want you to start moving your arm again. They’ll probably suggest physical therapy.

If your rupture isn’t serious enough to require surgery, you’ll probably recover in a few weeks.

If you had surgery to repair a torn biceps, it may take two to three months to heal. But it will probably take another month or two before you regain your full strength.

You may need to wait that long before you can return to high-impact sports or lift anything heavy. Ask your doctor what guidelines you need to follow to avoid injuring yourself again.

You can lower your risk for a biceps tendon rupture if you:

Treat tendon problems early. For example, tendonitis causes swelling and irritation, which can weaken the tendon if left untreated.

Limit repeated overhead movements. Lifting over your head again and again, whether at work or during sports such as baseball, swimming, or golf, can strain your biceps tendon.

Improve your posture. Sitting and standing up straight helps your muscles and tendons work better.

Use proper lifting techniques. Face the object, stand centered, and use both hands when reaching overhead.

Warm up before activity. Stretch for at least five minutes before working out.

Ease into new or harder tasks. Go slowly when increasing weight, intensity, or doing a new physical job.

Ask for help at the gym. A personal trainer can show you how to use equipment safely.

Stop if something hurts. Don’t push through sharp or unusual pain in your arm — or anywhere else.

A biceps tendon rupture can be painful, but with treatment, you’ll likely get most or all of your arm function back. Sometimes, at-home care and physical therapy are enough. Other times, the tendon needs to be reattached to the bone with surgery. See a doctor right away if you think you may have one. Torn tendons are easier to fix soon after the injury.

How do you tell if you tore your bicep?

You may feel a sudden, sharp pain in your upper arm. You might also hear a pop and see bruising or a bulge in your arm. But to confirm if you have torn your biceps, a doctor needs to check it.

Can you live a normal life with a torn bicep?

How well you function with a torn biceps depends on how serious it is and which tendon is hurt. Without surgery for a ruptured tendon near your elbow, you may lose 30%-40% of your usual strength in that arm. If you tore a shoulder tendon, you’ll probably be able to function close to normal, as most of the time, only one of the two biceps tendons is torn. 

What are the complications of bicep tendon repair?

Complications from biceps tendon repair can include excess scar tissue, abnormal bone growth, nerve damage, and loss of some muscle function. Talk to your doctor about what to expect from your surgery and what you can do to avoid complications.