If a rupture occurs, the long head will usually fall distally toward the elbow. Biceps muscle function usually remains nearly normal because of its dual attachment proximally. Initially, rest, ice, and gentle anti-inflammatory medications are all that is usually needed. Sometimes an injection with a strong anti-inflammatory medication such as cortisone is needed to control the pain and swelling. Severe cases which fail to improve may require surgical treatment.
Surgical treatment depends on the nature and extent of damage to the tendon.
If a significant portion is involved, a biceps tenodesis may need to be performed. If the biceps tendon is completely rupture, causing the muscle to bulge in the upper arm, a tenodesis can be done only if the distal portion remains near the top of the shoulder. A tenodesis is not done if the tendon slides too far distally because doing so would require unacceptably large incisions. A simple sling is all that is needed for the first few weeks after surgery. Immediate use of the hand is encouraged, but only for very light objects.