In the first of this 2-part series, Chris Mallac looks at the anatomy and biomechanics of the biceps brachii muscle, the mechanisms of injury, and the typical signs and symptoms that may alert a clinician to a biceps tendon rupture.
Athletes in contact and strength-based sports place an enormous amount of stress onto the distal bicep tendon. However injuries to the distal biceps tendon are not common in athletes, accounting for 10% of all bicep tendon ruptures, with the long head of the proximal insertion rupturing most frequently. If an injury to the distal bicep tendon does occur, it usually in the dominant arm of middle aged men (40-60yrs), suggesting a degree of degeneration must be present to rupture.
There have been a growing number of case reports in the media about these injuries – in particular athletes such as powerlifters and bodybuilders with a history of anabolic steroid use. More recent studies have shown that the incidence of this injury is increasing and the age group that sufferers is getting younger. It is believed that full tendon ruptures will require surgery to restore the biceps role as an elbow flexor and supinator of the forearm to prevent loss of strength in these movements.
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