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Biceps rupture

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Understanding that online help can not substitute for in person, I was wondering if you could tell me what kind of injury this may be (my worries is that it might be a tendon tear). I have a burning sensation in my left bicep from working out (for a few weeks now). My bicep is swollen (no redness or bruising) and I constantly get a feeling of tightness in the skin there too. When I flex it, the inside bottom portion of my bicep will droop down towards the elbow (unlike my other arm). There was no specific point that I remember injuring it , so no pop or snap that caused it. Thanks -Mike

Category: Orthopedic Surgeon

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Category: Spine Surgeon
 32 Doctors Online

Hello,

Thank you for your consult at DoctorSpring.com. I have read your query with diligence.

It looks from your details that you may have partial rupture of biceps tendon. The photograph is also denoting that. If there is pain in arm when you flex the elbow with resistance then this can be a indicative sign for that.

At present you should have a MRI investigation to confirm that.

You should avoid heavy movements.

Take a good analgesic .

Consult to a orthopedic doctor at a good hospital.

Hope this will help you. Please feel free to get back with more queries.

With best wishes.


Patient replied :

Hello Dr,
Thank you for the information. I do have a follow up question. I recently received an MRI which came back normal that I do not have tendon tears. Is there anything else that you can think of what this could be? Oh the lump that hangs from the bottom of my bicep, when I flex, it pulls up into my bicep and disappears as to look normal, then if I relax, that buldge will droop down again. No pain with any movement or flexing but just sometimes burning sensation throughout my arm and my skin feels tight all around my arm. Thanks again. -Mike


Hello Mike,

Sorry for the delay in my reply.

The picture and the description is actually suggestive of ruptured (partial) biceps tendon. Well if the MRI is negative then we need to look for other causes. Is it possible for you to share the MRI cuts ? Or the report will do.

I would also like to know who quickly this swelling developed ? (over days / months / years ). Also how does it feel ? Firm / hard / cystic or just like normal muscle ?

Do you feel this bulge is connected to the rest of the muscle or are you able to move it freely ?

You can reply as a followup
Thank you


Patient replied :

I dont have access to the MRI cuts because the military has them. Unfortunately I am not getting much help from them. The swelling developed overs days I believe. Its hard to tell because it was never really painful. I just figured that my muscles were tight from working them real hard and then after it not going away for days I looked in the mirror to see if I could see anything wrong. That is when I noticed the inside portion of it hanging lower. The portion that hangs lower feel very soft, then when I flex and rotate my palm up it disappears. I dont think I can move it freely because it doesnt feel like anything, it almost feels like fluid. There is no pain but i notice it all of the time because when my arm flexes it feels like someone finger is rubbing the underside of my skin in that area (if that makes any sense). When you say its suggestive of partial rupture, do you mean that the long or short head has torn completely or do you mean that one of those heads is partially torn? Also if i tore the tendon, wouldnt the bump just stay there and not contract when I flex? Thanks again for your help.



Hello Mike,

Bicep tendon injuries can occur from a single incident, or can occur gradually from repetitive movements and long term use. Since you say that the swelling developed over days, yours is probably a gradual injury due to repetitive movements. Biceps have 3 tendons, the long head and short head attached to the shoulder and one attached to the elbow called distal biceps tendon. Long head tendon injury is most common. When I say head is partially torn, I mean one tendon is partially torn. In partial tears functionality will still be there.
Also when you contract the bump will become more prominent, it will not stay the same through out.
But your description is not typical for tendon rupture. If you do not have access to the MRI, you can discuss with your Doctor what is the nature of the swelling (like what makes up the swelling - is it a cyst / muscle / blood as in hematoma ). Anyhow the good thing is that no immediate intervention is not needed whatever the case may be. Rest the arm for 7 days and then re evaluate. DO NOT exert the arm.

I hope this has helped.
Thankyou


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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