Distal Biceps Rupture
A distal biceps rupture is when the biceps tendon tears off the bone at the front of the elbow — usually during a sudden heavy lift — often with a pop, bruising, and noticeable loss of strength.
What is a distal biceps rupture?
The biceps attaches at the elbow on the radius bone. When the arm is forced straight against a heavy load — catching a falling object, lifting something too heavy — the tendon can tear off the bone. Unlike a biceps tear at the shoulder, a distal rupture causes meaningful loss of strength, especially in turning the forearm (supination), so repair is often recommended — and sooner is better.
Symptoms to watch for
- A sudden, painful pop at the front of the elbow during a lift
- Pain, swelling, and bruising at the elbow and forearm
- Weakness bending the elbow and especially rotating the forearm
- A change in the shape of the biceps muscle (it may bunch up toward the shoulder)
How it is diagnosed
A physical exam — including a "hook test" feeling for the tendon — is often enough, and an MRI confirms the diagnosis and shows whether the tear is partial or complete.
Treatment
Non-surgical management is an option for lower-demand or older patients willing to accept some loss of rotation strength. For most active patients, surgical reattachment of the tendon to the bone is recommended, ideally within the first few weeks, because the tendon retracts and scars over time, making later repair harder.
Sudden pop and bruising at the front of your elbow?
This is time-sensitive — an early evaluation matters.
Common questions
It is time-sensitive. Repair is most straightforward within roughly the first two to three weeks, so prompt evaluation is important if you want the tendon reattached.
Typically yes — especially strength turning the forearm. Some lower-demand patients accept this; most active people choose repair.
Protected motion early, then progressive strengthening, with return to heavier lifting over several months. A structured rehab protocol guides the timeline.
Both techniques are used to reattach the tendon. Dr. Hachadorian will discuss which approach suits your injury.
This page is for general education and is not a substitute for an in-person evaluation. Your specific diagnosis and treatment plan should come from Dr. Hachadorian based on your exam and imaging.