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AC Joint & Bicep Injuries


The biceps tendon attaches muscles to the shoulder in two separate places and helps bend the elbow and rotate the forearm, while the acromioclavicular (AC) joint involves the junction of the acromion and clavicle bones, often marked by a small bump on the shoulder.

Injury to these structures can occur as a result of age, over-activity, a fall or other type of trauma and can result in inflammation or a partial or complete tear. These injuries can cause severe pain, bruising and weakness.

Surgical treatment depends on the type and severity of the condition. Many of these procedures can be performed through arthroscopy for less scarring, less bleeding and shorter recovery times, and may include removing damaged joint ends, shaving away torn fibers or reattaching torn tendons.


Bicep Tendon Tears

Bicep tendon tears can happen at either the shoulder or the elbow andcan be partial or complete. A complete tear means the tendon has torn away from the bone. Tendons may fray and eventually tear in cases of serious or constant overuse. Also, a tendon can tear as part of an injury, such as moving or twisting your elbow or shoulder in an awkward way, or falling down with your arm outstretched. At the elbow, the bicep tendon most often tears during lifting a heavy object.


What Are the Symptoms of a Biceps Tendon Tear?

You may hear or feel a “pop” when a tendon tears. The most obvious symptom will be sudden, severe pain in the upper part of your arm or at the elbow, depending on where the tendon is injured. Other symptoms include:

  • a bruise that appears on the upper arm
  • a feeling of weakness in the shoulder or elbow
  • trouble rotating your arm from a “palm up” to a “palm down” position
  • a change in the contour of the front of your arm

A bulge may also appear in your arm, because the tendon is no longer holding the muscle in place properly. Tears at the level of the elbow more often require operative repair. In many case, people with a torn tendon can still function normally. Symptoms can be relieved by:

  • using cold packs or ice to reduce swelling
  • using nonsteroidal anti-inflammatory medications, such as aspirin or ibuprofen for relieving pain
  • avoiding heavy lifting, especially over your head
  • physical therapy


Tears at the Shoulder

Two tendons attach the biceps muscle to the shoulder: the “short head” that attaches the muscle to the shoulder blade and the “long head”tendon that attaches the muscle to the top of the shoulder’s socket. Usually, tears are more likely to occur in the long head, but even in the case of a complete tear of the long head tendon, the short head tendon may allow you to continue using your biceps muscle. Short head tendon tears are very rare.


Tears at the Elbow

Only one tendon attaches the muscle to the elbow and is called the distal biceps tendon. These tears are unusual and most often result from an injury or lifting a heavy object. When this tendon tears, the tear is usually complete and the muscle is separated from the bone.

Surgery may be the best option in both cases. For those who continue to experience symptoms after non-surgical treatments or who want all of their arm strength back, surgery is highly recommended. Most people with a torn distal tendon will still be able to move their arms reasonably well, but those who choose to have surgery to regain their arm strength need to do so quickly, because both the distal tendon and the muscle begin to scar 2-3 weeks after the tear and surgery may not be possible.

Physical therapy will be required for the surgically repaired tendons to heal completely, which will last for several months.

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