Proximal Biceps Tendon Rupture – Restoring Arm Strength and Shoulder Function

Overview

 

A sudden sharp pain in the upper arm or shoulder, followed by a visible bulge or loss of strength, is often a sign of a proximal biceps tendon rupture.
This injury occurs when the tendon that connects the biceps muscle to the shoulder tears, partially or completely detaching from the bone.

At Dr. Burke Orthopedics, we specialize in diagnosing and treating tendon injuries that affect both the shoulder and upper arm.
Led by Dr. Robert L. Burke, a board-certified orthopedic surgeon, our team provides personalized care to help patients across Pearland, Houston, Friendswood, and Southeast Texas regain strength, motion, and confidence after a biceps tendon rupture.

Understanding a Proximal Biceps Tendon Rupture

 

The biceps muscle has two tendons that attach it to the shoulder:

  • The long head connects to the top of the shoulder socket (glenoid).
  • The short head attaches to the coracoid process, a bony prominence on the shoulder blade.
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proximal rupture typically involves the long head of the biceps tendon tearing near the shoulder joint. This may happen suddenly during heavy lifting, a fall, or even with normal activity in individuals with prior tendon degeneration.

The injury often causes a “Popeye deformity”—a visible bulge in the upper arm as the torn muscle retracts downward

Common Causes and Risk Factors

 
Commmon Causes:
  • Sudden lifting or pulling motion with resistance.
  • Overuse or repetitive overhead movements (common in athletes and manual laborers).
  • Tendon weakening from age-related degeneration.
  • Shoulder impingement or rotator cuff tendonitis that irritates the biceps tendon.
  • Corticosteroid use that weakens connective tissue.
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Risk Factors:

  • Age over 40.
  • Smoking (reduces tendon blood flow).
  • Previous shoulder or tendon injuries.
  • Chronic shoulder instability or arthritis.
  • Overhead or heavy-lifting occupations.
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Understanding these factors helps Dr. Burke personalize a prevention and recovery strategy tailored to your lifestyle.


Symptoms

 

A proximal biceps tendon rupture usually presents with dramatic but specific symptoms.

Most common signs include:

  • Sudden, sharp pain in the shoulder or upper arm.
  • Audible “pop” at the moment of injury.
  • Visible bulge (“Popeye” muscle) in the upper arm.
  • Bruising that develops over the upper arm or shoulder.
  • Weakness when bending the elbow or rotating the forearm.
  • Cramping or fatigue in the biceps muscle.
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Pain often subsides after the initial tear, but weakness and cosmetic changes may persist without treatment.

Diagnosis

 

At Dr. Burke OrthopedicsDr. Robert L. Burke conducts a detailed assessment to confirm the diagnosis and determine if surgery is necessary.

Diagnostic process includes:

  • Medical history: Reviewing injury mechanism, prior shoulder problems, or degenerative symptoms.
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Physical examination:

  • Observing muscle contour and symmetry.
  • Palpating for gaps or tenderness along the biceps tendon
  • Testing shoulder and elbow strength.
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Imaging:

  • X-rays: Rule out associated fractures or arthritis.
  • MRI or Ultrasound: Confirm tendon rupture and assess damage to nearby structures such as the rotator cuff.
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A precise diagnosis ensures an individualized treatment plan for optimal recovery.

Treatment Options at Dr. Burke Orthopedics

 

Treatment depends on the patient’s activity level, degree of tendon damage, and strength goals.
Many partial ruptures and low-demand patients can recover without surgery, while active individuals often benefit from surgical repair.

Non-Surgical Treatments

For patients with minimal functional loss or partial tears, conservative care can yield strong results.

Non-surgical options include:

  • Rest and activity modification: Avoid heavy lifting and overhead activity.
  • Ice therapy: Reduces pain and swelling in the early phase.
  • Anti-inflammatory medications: To relieve discomfort and inflammation.
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  • Gentle range-of-motion and stretching exercises.
  • Gradual strengthening of shoulder stabilizers and remaining biceps tendon.
  • Focus on restoring function for daily activities.
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  • Platelet-rich plasma injections may enhance healing for partial ruptures or chronic tendon degeneration.
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Many patients regain comfort and mobility within 4–6 weeks of guided therapy.

Surgical Treatments

If the rupture is complete or significantly affects function, Dr. Burke may recommend surgical repair to restore the tendon’s normal position and strength.

Surgical options include:

Surgical options:

  • Plantar Fascia Release:
  • Biceps Tenodesis: The torn tendon is reattached to the upper arm bone (humerus) to restore appearance and power.
  • Biceps Tenotomy: The damaged tendon end is released to alleviate pain and prevent impingement (used for select patients).
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  • Minimally invasive technique that allows precise repair of the tendon and treatment of any associated shoulder issues, such as rotator cuff tears.
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Reconstructive Surgery

May be considered in rare cases where additional soft-tissue stabilization is required.

Recovery and Rehabilitation

 
  • Non-surgical treatment: 4–6 weeks for pain relief and mobility restoration.
  • Surgical repair: 3–6 months for full recovery, depending on tendon healing and physical therapy progress.
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Rehabilitation Focuses:

  • Gradual increase in shoulder and elbow motion.
  • Progressive strengthening of the biceps and shoulder stabilizers.
  • Avoiding heavy lifting for the first 8–10 weeks post-surgery.
  • Restoring full strength and range of motion under guided supervision.
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Most patients return to normal activity within 3–6 months, with excellent long-term results when therapy is followed closely.

Long-Term Outlook and Prevention

 

With proper treatment and ongoing foot care, most patients fully recover from plantar fasciitis and resume normal activity.

Prevention tips:

  • Warm up properly before lifting or overhead work.
  • Strengthen rotator cuff and shoulder stabilizers.
  • Maintain balanced posture and joint alignment.
  • Avoid overexertion and repetitive strain on the shoulder.
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Dr. Burke emphasizes long-term maintenance to keep shoulders healthy and strong.

When to Seek Medical Care

 

You should schedule an appointment with Dr. Burke Orthopedics if you experience:

  • Warm up properly before lifting or overhead work.
  • Strengthen rotator cuff and shoulder stabilizers
  • Weakness lifting or rotating the arm.
  • Loss of shoulder stability after an injury
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Prompt orthopedic evaluation ensures faster recovery and prevents complications.

Regain Strength and Confidence with Dr. Burke Orthopedics

At Dr. Burke Orthopedics, we believe that no patient should live with preventable weakness or pain.
Whether your biceps tendon injury is new or chronic, our team provides advanced, personalized treatment to help you return to the activities you love — safely and confidently.

Call (713) 436-3488 or Request an Appointment Online
Serving Pearland, Houston, Friendswood, and Southeast Texas — where orthopedic expertise meets compassionate care.

Medical Disclaimer:

This information is provided for educational purposes only and is not a substitute for professional diagnosis or treatment. Always seek advice from a qualified healthcare provider regarding shoulder or arm pain, swelling, or deformity. If you experience sudden weakness or a visible muscle bulge after injury, seek immediate medical care.

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