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The biceps muscle, located in the front of the upper arm, allows bending of the elbow and rotation of the arm. Biceps tendons attach the biceps muscle to the bones in the shoulder and in the elbow. Biceps tears can be complete or partial. Partial biceps tendon tears will not completely break the tendon. Complete tendon tears will break the tendon into two parts. Although two tendons attach the biceps muscle to the bone at the shoulder, only one tendon attaches it to the elbow. This is known as the distal biceps tendon. Tears of the distal biceps tendon are usually complete, and the muscle/tendon is separated from the bone. Tears of the distal biceps tendon most often result from a sudden injury or lifting a heavy object. In case of overuse, a tendon may fray and eventually tear. The most common symptom is a sudden, severe pain in the upper arm or at the elbow, depending on where the tendon is injured. At times you may hear a “pop.” Other symptoms include swelling, visible bruising, weakness in the shoulder or elbow, and trouble turning your arm palm or palm down. A biceps tendon tear is usually diagnosed based on symptoms, medical history, and physical examination. During the physical examination, the physician will look for a gap in the front of the elbow. You may have pain if there is a partial tear. X-rays may be taken to rule out other conditions causing shoulder and elbow pain. Using an MRI scan, your doctor can determine whether the tear is partial or complete. Conservative treatment for a proximal biceps tendon tear includes ice application, limiting activity, and non steroidal anti-inflammatory medications to reduce the pain and reduce swelling. To restore mobility and strengthen the surrounding muscles, your doctor may prescribe certain flexibility and strengthening exercises. Surgery may be required to reattach the torn tendon back to the bone.

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