Popeye's Torn Biceps Tendon

When children want to show how strong they are, they flex the upper arm and point to the bulge. This is the biceps muscle. It attaches to the shoulder and to the elbow in two parts. One part helps lift the arm, and the other bends the elbow.

When the biceps muscle is torn, it sometimes bunches up and makes a bulge. This happens even when the person isn't trying to "make a muscle." This is called the Popeye deformity. Interestingly, when a doctor cuts the biceps tendon, the muscle doesn't bunch up or change the way the arm looks. This is probably because the doctor cuts the biceps tendon up high enough in the shoulder that the tendon gets caught in a groove in the bone and stays there. A torn biceps muscle pulls back into the main part of the muscle and causes a bulge.

For people with shoulder pain and muscle spasm from a biceps problem, doctors want to know what surgery works best. Is it better to cut the tendon and let it reattach by itself? Or is it best to cut the tendon and sew it in place?

In the long run, it doesn't matter which operation is used. Pain and spasm are gone and no "Popeye" deformity is visible with either method. This is equally true for both men and women. In the short term, cutting the tendon without reattaching it results in less pain and less time off work.

A torn biceps tendon can be repaired with one of two different operations. It can be cut and allowed to reattach by itself, or it can be cut and reattached with stitches. When deciding what type of surgery is needed for a painful biceps tendon, doctors may be helped by knowing that the end result is the same with either method.

Reference: 

Daryl C. Osbahr, B.S., et al. The Cosmetic Appearance of the Biceps Muscle After Long-Head Tenotomy Versus Tenodesis. In Arthroscopy. May-June 2002. Vol. 18. No. 5. pp. 483-487.

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