What to Know About Biceps Rupture

Medically Reviewed by Carol DerSarkissian, MD on May 28, 2023
4 min read

A biceps rupture is a major arm injury. Your biceps muscles are located in your upper arms, and they’re responsible for the motion of your shoulder and elbow. The biceps muscle has two tendons (long head tendon and short head tendon)  that attach it to the bones of the shoulder, and the distal tendon that attaches it to the radius bone at the elbow. A biceps rupture occurs when you tear one of these tendons.‌

If you sustain damage to these tendons, it can rupture painfully. When this happens, your biceps will tense into a painful ball that resembles the arms of the 1930’s cartoon character Popeye, which is why this injury is sometimes called a “Popeye’s muscle” or “Popeye Deformity”.

Biceps rupture can happen over time because of overuse, or suddenly due to an injury. As we get older, the tendons can wear down until they tear. Making the same types of movements over and over again can make this process happen even faster. Several kinds of injuries can also cause the tendons to tear, such as falling on your arm while it's outstretched, twisting your arm or shoulder, or lifting or catching something heavy. 

Most tears occur when your tendons are already weakened by a preexisting condition like tendonosis. If you’re a smoker, or if you aren’t physically active, you may be more susceptible to a biceps rupture. 

A biceps rupture happens quickly, so you may feel a sudden and severe pain in your arm along the biceps muscle. You may also hear or feel a popping sensation. Other signs of a biceps rupture include:

  • Sharp pain in your shoulder or elbow
  • A bruise that appears near the site of the pain
  • Weakness in your shoulder or elbow
  • Difficulty rotating your arm 
  • A noticeable swelling or curling of the biceps

It’s important that you not panic, because this injury isn’t life-threatening, but you need to see a doctor immediately if you suspect that you have ruptured your biceps. With quick treatment, you’ll likely regain your full arm function. Within weeks, the tendon will scar, and treatment becomes more difficult.

During a physical exam, your doctor looks for visual signs of a rupture, as well as weakness or immobility of your arm.

Your doctor may use an x-ray or MRI scan to rule out other injuries and make sure that you get the proper course of treatment. These diagnostic exams also show the severity of the tear, which will determine what the next steps are. You may have a partial tear, or the tendon might be completely severed from your arm.

Quick treatment is the key to ensuring your biceps tendon heals completely following a rupture. If you have a partial tear, your doctor may recommend:

  • Using ice or cold packs to keep the swelling down and manage your pain
  • Resting and avoiding heavy lifting or extreme movements of your arm
  • Pursuing physical therapy to promote healing and strengthen the surrounding muscles
  • Corticosteroid injections in severe cases to prevent inflammation

If your tendon has completely disconnected from your shoulder or elbow, you’ll need surgery to reattach it. The specific details of the surgery will depend on your injury, but technological advances mean that minimally invasive surgery is possible, and you may avoid a large incision or scar. You’ll need to do physical rehabilitation to regain your previous mobility, but this usually only takes a few months.

Once you’re completely healed, it’s important to avoid the activity or motion that caused the tear to begin with. Warm up your muscles before doing strenuous activities and stop if you feel any pain. Pursue strength training if you’ve lost strength during your rehabilitation so that you can resume your usual activities.

If the rupture was caused by an underlying condition, like tendonosis, your doctor may recommend a course of treatment for that as well. Tendonosis, a chronic condition in which tendons becomes thick and rubbery, can be treated with a minor surgery.

A biceps rupture can be very painful, but you’ll likely get your full arm function back after treatment. Make sure to get to the doctor right away if you think you’ve torn your tendon, and follow any treatment guidelines carefully.