A bicep bulge is an injury that typically results from a tendon tear and is sometimes referred to as a “Popeye deformity.” When one of the tendons attached to the bicep muscle is torn, it causes the bicep to contract into a ball-like shape that is reminiscent of the exaggerated bulging arm muscles of a certain cartoon sailor.
The Anatomy of your Arm
To understand exactly what a bicep bulge is, it’s important to be familiar with the structure of your arm. The bicep is a muscle in between your elbow and shoulder that helps you rotate your arm and bend at the elbow. There are two sets of tendons that attach the bicep to bone:
- Proximal tendons: These two tendons attach the top of the bicep to the shoulder. The long head of the bicep tendon connects to the glenoid, which is in your shoulder’s socket. The short head of the bicep tendon attaches to your shoulder blade. Around 96% of bicep bulges involve the long head, while only 1% involve the short head.
- Distal tendon: Located near the elbow, this tendon attaches the bicep muscle to the radius bone. This type of tendon tear is more severe but also significantly less common, with only about 3% of bicep bulges being caused by a distal tear.
Causes and Symptoms
Bicep bulges can be caused by the following:
- Overuse: Repetitive motions, especially with heavy weight, can cause an overuse injury. Exercises like bicep curls or overhead presses with too much weight can put strain on the bicep muscle and cause the tendons to fray over time and eventually tear. This can also happen in jobs that require repetitive pushing, pulling, or heavy lifting.
- Sudden injury: Falling, lifting or catching a heavy weight, or forceful trauma during contact sports can cause tendon tears resulting in a bicep bulge.
- Age: Wear and tear over the years can weaken your tendons and eventually cause them to tear partially or completely. Even though bicep bulges can happen to a person of any age, they are most common in people older than 50.
However, these causes vary based on if you experienced a proximal tear or a distal tear.
“Usually tears occur within the proximal tendon due to problems within the shoulder, such as arthritis or an issue with the rotator cuff,” says Peter Chalmers, MD, an orthopedic surgeon at University of Utah Health. “Tears of the distal tendon are more common with a traumatic injury, especially if someone is lifting something too heavy and that weight shifts and loads onto the bicep, causing that tendon to tear.”
When a tendon tears and causes a bicep bulge, you may experience the following symptoms:
- A visible lump or bulge in the upper arm
- Hearing or feeling a pop or snap
- Sudden, sharp pain in the arm or elbow when the injury occurs
- Bruising and swelling in the upper arm or elbow
- Weakness and reduced range of motion
- Pain when attempting to use your bicep muscle
Outlook After a Bicep Bulge
Treatment for a bicep bulge will depend upon your specific injury and the severity of the tendon tear. Seeing an orthopedic specialist can help you decide the best course of treatment for you so you can return to activities pain-free.
- For partial tears or proximal tears, non-surgical options may be enough. These include:
- Wearing a sling or brace to limit movement
- Resting and taking time away from activities that require use of your arm
- Pain management with anti-inflammatory medication or cold therapy to reduce swelling
- Physical therapy to strengthen your arm and regain mobility
Most people only need a few weeks to recover from a proximal tear.
“While most proximal tears can be treated with non-operative measures, the opposite is true of distal tears,” Chalmers says. “Tears close to the elbow generally lead to substantial weakness, and it’s best for those to be repaired within a couple of weeks of the injury. If patients come back months later to have the surgery, it may not be as simple to repair.”
It may take several months to fully recover from a distal tear, and physical therapy will be an important component to your recovery.
While accidents and unexpected injuries can happen, there are ways to prevent tendon injuries that lead to a bicep bulge. It’s important to always do a proper warm-up and cool down after physical activity, learn proper form and technique, and take breaks if your job requires repetitive motions and heavy lifting. If you must lift something heavy, be sure to have adequate help.
