Rupture of the Distal Biceps Tendon at the Elbow

The biceps muscle connects to the bone by the biceps tendon, which crossed the front of the elbow. The bicep muscle is responsible for turning the palm up (supination) and helps to bend (flex) the elbow. A distal biceps tendon rupture is a full or partial tear of this tendon.  Rupture of the distal biceps tendon can be sports-related, occur when lifting a heavy weight or when the arm is bent and suddenly forced to straighten.

Causes of Distal Biceps Tendon Rupture

The most common way to rupture a distal bicep tendon is either during an unexpected extension of the elbow or with a sudden straightening force to the elbow.

The injury is most common in men between the ages of 40-60, though research has shown it can happen at any age to either gender.

The rupture itself is typically a sudden event. However, studies show a variety of degenerative, hypovascular, and mechanical factors contribute to or cause the tear. Use of anaboloic steroids and nicotine are also related to an increase in distal bicep tendon ruptures.

Signs and symptoms of an Rupture of the Distal Biceps Tendon at the Elbow may include:
  • Pain, swelling and/or bruising in the front of the elbow
  • Weakness in the affected arm when bending or twisting the elbow
  • Inability to feel the tendon and/or seeing the biceps muscle belly pull up towards the shoulder
  • Asymmetry in the bicep muscle
  • A sudden snap, pop, or giving way of the elbow

The doctor may recommend resting the elbow and modifying activity to help relieve pain and swelling. Although this will eventually help with bending the elbow, there will be a decrease in power when twisting the elbow and most often surgery within the first several days of the injury is recommended.


Surgery involves reattaching the tendon to the bone. Surgery is currently the recommended treatment in active patients of all ages who have sustained a full tear of the distal biceps tendon. Several surgical techniques exist that provide good anatomic reinsertion of the biceps tendon. Your surgeon will determine the technique best suited for your injury.


Certified Hand Therapists can custom fit splints for the joint. The splint acts a brace to support the joint and limit stress placed on the joint during activity. A sling or other advanced support may be used.

Hand/Elbow Therapy

Certified Hand Therapists work closely with doctors to create a customized therapy and rehabilitation program to restore function to the elbow. They equip patients with the materials and exercises they need to maximize recovery.