---
title: "Long Head of Biceps Tear: Treatment | Dr. Avi Chezar"
description: "Long head of biceps tendon tear: the typical presentation and \"Popeye\" sign, diagnosis, why surgery is usually not needed, and timing if repair is chosen."
canonical: https://www.catef4u.com/en/biceps-tear
translation-of: https://www.catef4u.com/biceps-tear
last-updated: 2026-11-03
language: en
source: catef4u.com
---

# Biceps Tendon Tear

> Long head of biceps tendon tear: the typical presentation and "Popeye" sign, diagnosis, why surgery is usually not needed, and timing if repair is chosen.

Tear of the long head of the biceps tendon

## In brief

Summarized and reviewed by Dr. Avi Chezar, shoulder surgery specialist, Assuta Haifa and RMC Afula.

**What it is:** A tear of the tendon of the long head of the biceps muscle, common with age as a result of gradual weakening of the tendon. It can be caused by unusual exertion, and is also common in people who do bodybuilding.

**Symptoms:** Sharp pain in the upper arm after lifting a heavy weight, difficulty bending the elbow against resistance, and bruising of the arm at first. Later a lump appears in the arm that bulges when the muscles are tensed – the "Popeye" sign.

**Diagnosis:** The diagnosis is mainly clinical, based on the typical findings, including the "Popeye" sign. It can be confirmed with an ultrasound or MRI if needed.

**Treatment:** In most cases surgical repair is not needed, because function is not significantly affected. If surgical repair is decided on, it should be done early – within about 3 weeks of the injury.

## How does it typically present?

Sharp pain in the upper arm that appears after lifting a heavy weight or a sudden load on the arm.

It can also be a gradual process, without a clear injury.

In an acute tear, sharp pain is felt in the upper arm, followed by difficulty bending the elbow against resistance. At first bruising of the arm may be seen, and later a kind of lump appears in the upper arm that bulges when the arm muscles are tensed. This is known as the "Popeye" sign.

## What causes the tear?

With age the tendons weaken, which can lead to a tear, mainly during unusually heavy exertion. It is also common in people who do bodybuilding and train with heavy weights.

## How is a tear diagnosed?

The diagnosis is mainly clinical, based on typical findings on physical examination, including the "Popeye" sign.

Usually no additional tests are needed for the diagnosis; a targeted ultrasound or MRI can be done to help with the diagnosis.

## How is a tear treated?

In most cases there is **no** need for surgical repair, because function is not significantly affected.

If a repair is done, it should be done as early as possible – within about 3 weeks of the injury.

The repair is done with an open technique, through an incision at the top of the upper arm near the armpit.

The reason for surgery is usually cosmetic. Bear in mind that even after surgery there will be a scar in the area of the operation, and there may be pain during activity with the arm.

After this injury, it is advisable to consult a specialist and discuss the treatment options.

If surgery is being considered, the consultation should take place as soon as possible after the injury.

## Further reading from leading medical sources

- [Biceps Tendon Tear at the Shoulder — OrthoInfo (AAOS)](https://orthoinfo.aaos.org/en/diseases--conditions/biceps-tendon-tear-at-the-shoulder/) – Biceps tendon tear at the shoulder – symptoms and treatment

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_This Markdown is the text-only variant of the page above, served for `Accept: text/markdown`. It is an English translation of Dr. Avi Chezar's Hebrew page. Medical information here is general and does not replace a personal consultation._