From the Guidelines
Bicep tendon rupture is strongly associated with traumatic ruptures, particularly those involving the short head of the biceps tendon, as well as atraumatic ruptures, which are more commonly related to the long head of the biceps tendon 1. When considering the associations with bicep tendon rupture, several key factors emerge. These include:
- Traumatic injuries, which have a higher association with ruptures of the short head of the biceps tendon 1
- Atraumatic ruptures, which account for 89% of long head of the biceps tendon ruptures 1
- Overuse injuries from repetitive motions, which can lead to tendon damage and increase the risk of rupture
- Certain medical conditions, such as rotator cuff injuries and shoulder instability, which can coexist with bicep tendon ruptures
- Inflammatory conditions like tendinitis, which can cause chronic inflammation and degrade tendon integrity over time
- Anatomical abnormalities, such as bone spurs, which can cause mechanical friction against the tendon
- Age-related degeneration, as tendons naturally weaken over time, particularly in individuals over 40 The use of MRI, particularly with noncontrast imaging and specialized views like the flexion-abduction-supination (FABS) view, has been shown to be useful in the assessment of biceps tears and distal biceps tendon pathology 1. The FABS view can provide an unraveled view of the distal biceps tendon, allowing for the visualization of the entirety of the tendon on a single image, and has been found to have better interrater reliability and accuracy in grading the extent of pathology compared to surgical findings 1.
From the Research
Conditions Associated with Bicep Tendon Rupture
- Biceps tendinitis and tendinosis are commonly accompanied by rotator cuff tears or SLAP (superior labrum anterior to posterior) lesions 2
- Local steroid injections in or about the tendons can lead to tendon rupture, including the long head of the biceps tendon 3
- Sports activities, particularly those involving overhead motion or high-energy throwing movements, can increase the risk of biceps tendon rupture 4
- Distal biceps tendon ruptures are more common in men between 40 and 60 years of age and typically occur when an unexpected extension force is applied to the flexed arm 5, 6
Risk Factors
- Age: Distal biceps tendon ruptures are more common in men between 40 and 60 years of age 5, 6
- Sports activities: Sports that involve overhead motion or high-energy throwing movements can increase the risk of biceps tendon rupture 4
- Local steroid injections: Injections in or about the tendons can lead to tendon rupture, including the long head of the biceps tendon 3
- Preexisting tendon degeneration: The rupture of the distal biceps tendon typically occurs at the tendon insertion into the radial tuberosity in an area of preexisting tendon degeneration 5