The biceps muscle in the upper arm has a tendon at either end.  In the shoulder, proximal biceps rupture is very common, and might be only a minor part of other shoulder pathology.  At the elbow, rupture of the distal biceps tendon is rare, but disabling.  A bit like Achilles rupture, it occurs suddenly, due to a forceful activity, then more weakness than pain.  Swelling and bruising ensure.

The vast majority should have surgery to restore the arm to full strength, it is easiest to do early..  Cases having surgery more than three weeks are regarded as late.  The surgery requires finding the tendon, and repairing to bone it through a bone trough in the radial tubercle.  Most commonly an Endobutton or Ziploop is pulled through the bone to maintain the tendon in position, much like is commonly done reconstructing the cruciate ligament in the knee.  Partial rupture of the biceps tendon at the elbow is exceedingly rare, need not have urgent surgery, but most likely pain will persist until a complete rupture occurs.

This image shows the Ziploop button, and with a good eye, it is possible to see the tunnel drilled through from the radial tuberosity. All our surgeons at Ballarat Orthopaedics perform surgery for biceps rupture.