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Shoulder

Proximal Biceps Tendon Tear

A proximal biceps tendon tear involves a partial or complete rupture of the long head of the biceps where it attaches at the superior glenoid. It commonly occurs in middle-aged and older adults and can be associated with rotator cuff tears. Partial tears cause pain; complete tears often produce the classic "Popeye" deformity.

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Typical Recovery Time
3–6 months post-surgery for return to full activity

Symptoms

  • •Sudden pop in the front of the shoulder
  • •Sharp pain followed by bruising in the upper arm
  • •Visible bulge or "Popeye" deformity in the lower arm (complete tear)
  • •Anterior shoulder aching
  • •Weakness with supination (turning palm up)

Common Causes

  • •Sudden heavy lifting or forceful elbow flexion
  • •Age-related tendon degeneration
  • •Associated rotator cuff tear
  • •Chronic tendinopathy progressing to rupture
  • •Repetitive overhead loading

Treatment Options

1Conservative management for partial tears or low-demand older patients
2Biceps tenodesis (surgical reattachment to humerus)
3Biceps tenotomy (cutting tendon, allows retraction) for low-demand patients
4Physical therapy for strength and function
5Activity modification during healing

When to See a Doctor

Seek evaluation if you felt a pop and noticed a change in arm shape — imaging helps distinguish partial from complete tears and guides treatment decisions.

Frequently Asked Questions

What is a proximal biceps tendon tear?
A proximal biceps tendon tear is a tear of the biceps tendon near the shoulder. This tendon helps with lifting and stabilizing the arm. When it tears, it can cause pain and weakness in the shoulder.
What causes a proximal biceps tendon tear?
It can occur from sudden lifting, trauma, or repetitive overhead activity. Over time, the tendon can weaken from wear and tear. It is often associated with other shoulder problems like rotator cuff disease.
What are the symptoms?
Symptoms include pain in the front of the shoulder, bruising, and sometimes a bulge in the upper arm. Some people feel a sudden pop at the time of injury. Weakness or cramping may also occur.
Do I need surgery?
Many proximal biceps tendon tears are treated without surgery, especially if function is acceptable. Physical therapy can help restore strength and motion. Surgery may be considered for persistent symptoms or higher activity demands.
How long is recovery?
Recovery typically takes several weeks to a few months depending on symptoms and activity level. Most people return to daily activities relatively quickly. Full return to sports may take longer depending on strength and comfort.
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