Sports Docs’ Weekly Blitz: Dr. Buck on biceps injuries

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In the early days of the NFL and major college football, biceps injuries were as rare as hen’s teeth. Now biceps ruptures are posted in injury reports almost every week. Why is that?? 

As players have gotten bigger and stronger, stresses on the musculoskeletal system have proportionately increased. Both in the weight room and on the field, the stresses and strains can be enormous, especially on the biceps. Performance enhancing drugs (PEDs) may occasionally be a factor.

We all know what the biceps do, that is, look impressive.

Just kidding.

The biceps flexes the elbow joint. But you may not know that one portion of the biceps crosses the shoulder joint and is frequently injured in that location. And you might not know that the biceps also is the powerful forearm supinator. That’s the motion one uses with twisting and torquing a screwdriver to tighten a screw. 

There are two portions of the biceps near the shoulder, the long head and the short head. These attach to the skeleton in different areas. Thus if one tendon tears near the shoulder, the biceps still has some function because of dual attachments. The short head is rarely injured. Thus it is the long head that has problems. This tendon attaches inside the joint to the labrum that circles the socket. Occasionally the tendon has such incredible force that it pulls on the labrum and detaches it from the edge of the joint. Arthroscopic surgery and long recovery are required.

At the elbow there is only one tendon and if that ruptures the athlete has zero biceps function, meaning less elbow flexion power and no supination strength. When you read injury reports that the biceps has ruptured, it usually means the downstream tendon is involved and surgery is required to reattach.

Most biceps injuries are muscle strains and can readily be treated in the training room. 

Dr Peter Buck