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Can You Train With a Torn Biceps? The Biceps-Rupture Audit: Where Every Rupture in the Founding Census Arrived Under Eccentric Load — the Arm Forced Out of Flexion — and Smokers Carried 7.5× the Risk Against a 9% Baseline; Where the Bedside Hook Test Went 100-for-100 Against MRI's 92/85 and the Partial Tear Hides From the Scanner at 59% Sensitivity; Where the Nonoperative File Reads 'Acceptable Outcomes With Modestly Reduced Strength' — Median Supination 63% vs 92% Surgical, Flexion Not Even Significantly Different; Where the Great Technique War Ends in a Tie That Trades One Nerve for One Bone and All Four Reruptures in the Landmark Trial Came From Noncompliance, Not Fixation; and the Field's Own 2026 Review of 614 Partial-Tear and Tendinopathy Patients Says Both Doors Work: the Torn Biceps's Medicine Is Naming Which Tendon Tore, Respecting the Retraction Clock, Training Everything Else From Day One, and Giving the Arm Its Calendar Back One Rung at a Time

By RightRep AI Assistant · · 25 min read

There is a fence at the top of this post and it outranks everything below it: a pop at the elbow crease during a heavy curl, a row, or the failed catch of a falling load — with the biceps muscle bunching up the arm, bruising, and a gap where the tendon used to sit — is the complete-rupture door, and it is a scheduling emergency: an orthopedic consult within days, not weeks, because the tendon retracts and the chronic window trades a straightforward reattachment for graft reconstruction [17]. The second fence: inability to extend the wrist or fingers after an elbow injury is the posterior-interosseous-nerve door — a nerve file that can ride along with the rupture or its repair, and it goes to urgent assessment today, not to a training question [13]. The third: a painful elbow that catches or locks, or an anterior-crease ache that has smoldered for months without a pop, is the partial-tear and tendinopathy door — a different file from the rupture, one where conservative care is the first door and surgery waits for the failed trial [1]. The fourth: a Popeye bulge high on the arm, above the middle of the biceps, especially with a rotator-cuff story behind it, is the proximal long-head door — a different tendon entirely, with its own verdict that tenotomy and tenodesis mostly tie [15]. The fifth: ruptures on both sides, or a rupture inside a history of anabolic-steroid use, is the tendon-quality door — a medical conversation about why the tendon failed before any conversation about programming [2][3]. The sixth: fever with rapidly escalating elbow pain after a repair is the infection door — back to the surgeon the same day. With the fences respected, the question underneath splits into the two scripts this injury-family library keeps convicting in opposite directions: the shut-it-all-down script ("arm's ruined, no more pulling, no more curls, rest it and accept it") and the push-through script ("it's just a strain, tape it and train"). The first wastes the months the rest of the body could have kept training and, after repair, violates the very calendar the rerupture file indicts; the second turns a partial tear into a complete one and a complete one into a retracted one. The evidence — from a 1985 Cybex file to a 2026 systematic review of 614 patients — rejects both, with numbers [4][1][10].

The short answer: train — everything the arm doesn't need, from day one, while the tendon's file gets named, the rupture gets its consult inside the retraction clock, and the repaired arm climbs a calendar whose verdict is written by the surgeon's protocol, not by how good the arm feels

Strip the file to its spine. The injury is rarer than the internet thinks and more consistent than almost any file in this family: a national database count puts distal biceps ruptures at 2.55 per 100,000 patient-years — 95% male, mean age 46, and the founding census could not find a single rupture mechanism that was not an eccentric load, the arm forced out of flexion [2][3]. The bedside beats the scanner: the hook test — one finger hooked under the taut tendon while the patient supinates against resistance — was abnormal in 33 of 33 complete avulsions and read the 12 partial tears correctly as intact (though painful in 9 of 12), outperforming MRI in the same cohort; and MRI's blind spot is exactly the file lifters care about, finding the partial tear only 59.1% of the time [7][9]. The nonoperative door is real: patients who never had the repair still scored well on function — a median Broberg-Morrey of 85, Mayo of 95, DASH of 9 — carrying a supination tax (median 63% of the other arm against 92% in historical surgical controls) but a flexion difference that did not even reach significance; "acceptable outcomes with modestly reduced strength" is the paper's own sentence [6]. The technique war ties: the randomized trial of single- versus double-incision repair found no final outcome differences at two years — both doors trade complications, one nerve for one bone, and the meta of 2,622 patients agrees there is no functional score difference at all [10][11]. The calendar is the surgery file's real boss: all four reruptures in that randomized trial came from noncompliance or reinjury in the early postoperative weeks — none from the fixation — which is the strongest possible statement that the first six weeks protect the repair, not the reverse [10]. And the partial door is a sequencing story: the 2026 systematic review found both operative and nonoperative management effective for partial tears and tendinopathy, with tendinopathy treated nonoperatively and surgery reserved for the high-demand arm after the conservative trial fails — and the surgical review's telling detail is that at least 65 of 86 operated partial tears had already been through that failed trial first [1][13]. Train legs, trunk, the other arm, conditioning — from day one; get the complete rupture seen inside the retraction clock; run the partial file conservatively first; and give the repaired arm back its load one rung at a time, on the protocol's schedule [1][4][10][17].

Who is asking: the scale file

The distal biceps rupture is the injury-family's rarest file and its most consistent. The modern census — a query of a national insurance database of public and private patients — estimated 2.55 ruptures per 100,000 patient-years nationally and 5.35 per 100,000 in the querying region's own population, with a mean age of 46.3, males making up 95% nationally and 96% regionally, and smoking and elevated body-mass index associated with the injury while diabetes showed no association at all [2]. The founding census, drawn from a defined healthcare membership over five years, found thirteen men and one woman at an average age of 47, the dominant arm involved in 86%, and — the number that reframes the whole file — 43% regular tobacco users against 9% of the membership, a 7.5-times greater rupture risk on Poisson regression [3]. The gym translation is direct: this is the mid-life male lifter's tendon injury, arriving on the dominant arm during the exact moment every curl, every row, every deadlift lockout loads — the transition from flexion under load [3]. It is not the tear of the young reckless; it is the tear of the 46-year-old who has been loading the tendon for decades, smokes, and asked the tendon to control a load it could once lift. The family has filed the pec's version of this story (the barbell's one big chest rupture, also a mid-life male eccentric file) and the tendon's chronic versions (the elbow's tennis elbow file, the knee's jumper's knee); the distal biceps is the acute tendon file of the same neighborhood — the arm's one big pop [2][3].

The mechanism door: one injury, one story

Every audit family has a mechanism file, and none is cleaner than this one. In the founding census, every single patient described the same mechanism: excessive eccentric tension as the arm was forced from a flexed position — the heavy curl collapsing on the way down, the falling object caught with a bent elbow, the arm yanked straight while the biceps was still pulling [3]. The physiology is the tendon's failure under load at its weakest address: the distal insertion on the radial tuberosity, a watershed zone of poor blood supply that the reconstruction literature implicates in both rupture and the poor healing of chronic retraction [17]. The pop is distinctive enough to be a diagnosis in the gym: sudden, sharp, at the front of the elbow crease, often with a sense of the arm "letting go," followed over hours by bruising tracking down the forearm and the muscle belly migrating up the arm as it loses its distal anchor [3][7]. Two risk numbers travel with the mechanism. Smoking multiplies risk 7.5-fold — the largest modifiable number in this file, and the honest answer to "how do I prevent a distal biceps rupture" starts there, not with any warm-up [3]. And dominance matters — 86% of the census ruptures hit the dominant arm — because that is the arm holding the load when the eccentric surprise arrives [3]. The door's practical sentence: the mechanism is a screening question, not a coincidence. An elbow-pop under an eccentric load in a 40-something male smoker is a distal biceps rupture until a clinician's hook test says otherwise [7].

The naming door: two tendons, one word

"Torn biceps" is ambiguous in a way "torn ACL" is not, because the biceps has two completely different tendons and the gym uses one word for both. The distal rupture — this file — is the tendon that crosses the elbow front and inserts on the radial tuberosity, the one that turns the screwdriver and the palm-up curl; its tear sits at the elbow crease, the muscle bunches upward toward the shoulder, and supination (not flexion alone) is what it costs [4][5]. The proximal long-head rupture — the other file — is the tendon that runs through the shoulder joint along the bicipital groove; its tear produces the classic Popeye bulge high on the arm, rides along with rotator-cuff pathology, and carries the field's calmest verdict: a randomized trial comparing cutting the tendon (tenotomy) against re-anchoring it (tenodesis) found no differences in function, quality of life, pain or strength at 6 and 24 months — more cosmetic deformity with tenotomy, nothing else that mattered, and the trial's own title states tenodesis is not superior [15]. This matters for the reader self-diagnosing a lump: a bulge at the elbow crease with an eccentric pop is the distal file — the consult inside the retraction clock; a bulge high on the arm in a shoulder that has been hurting for months is the proximal file — a shoulder conversation, frequently a nonoperative one [15][17]. The two files share almost nothing: different epidemiology, different mechanism, different surgery, different stakes — and every number in this audit belongs to the distal one unless explicitly stated [2][3][15].

The test door: the bedside beats the scanner

The distal biceps file owns the most satisfying diagnostic story in this library: the test that beat the MRI. The hook test — the patient actively supinates with the elbow flexed 90 degrees, and the examiner hooks an index finger under the biceps tendon from the lateral side — was performed in 45 patients headed to surgical exploration: abnormal in all 33 complete avulsions, correctly intact in all 12 partial tears, for 100% sensitivity and 100% specificity against the operative findings, while MRI in the same cohort ran 92% and 85% [7]. The companion bedside test, modeled on the Thompson test for the Achilles — squeezing the biceps belly and watching for supination — was positive in 24 of 25 consecutive rupture patients, confirmed operatively in 21 of 22 who went to surgery, still absent at three months in the two decliners, and present in all 65 untraumatized controls [8]. The honest asterisk is the partial tear, and it cuts both ways: the hook test cannot tear itself away from the partial file — intact but painful in 9 of the 12 partials — and MRI, the test everyone trusts to "clear" an arm, found the partial tear only 59.1% of the time in the blinded radiologist study, against 100% for complete tears [7][9]. The practical translation: a complete rupture is a bedside diagnosis — a clinician's finger and ten seconds; a symptomatic arm with a "clean" MRI is not a cleared arm, because the scanner's blind spot is precisely the partial tear this population carries; and the imaging that matters most, when a partial is suspected, is read by someone who knows the question [7][8][9].

The natural-history spine: what an unrepaired arm actually costs

The oldest file in this audit is still one of the best: thirteen rupture patients Cybex-tested fifteen months to six years out — the ten who had the two-incision repair returned to normal strength and endurance in both flexion and supination, while the three treated conservatively carried remaining deficits "clinically evident in several activities, such as use of a screwdriver or baseball bat" — the 1985 sentence that anchored forty years of surgical enthusiasm [4]. The modern nonoperative file is the necessary counterweight, because nobody should choose a surgery from a three-patient control group. Eighteen patients with twenty unrepaired ruptures, median 38 months out, were strength-tested and scored against historical surgical controls: median supination 63% of the uninjured arm (against 92% surgical, p = 0.002) but median flexion 93% (against 95%, p = 0.164 — not even significantly different), with function scores of Broberg-Morrey 85, Mayo 95 and DASH 9 — the paper's own conclusion being the sentence every candidate should hear: "acceptable outcomes with modestly reduced strength, especially supination" [6]. Read together, the two files write the honest paragraph: the unrepaired arm keeps most of its life — flexion nearly whole, function scores good — and pays a real, measurable supination tax, the screwdriver-and-door-handle motion, the palm-up half of every pull and curl [4][6]. Who chooses which door is therefore a values question with numbers attached: the older arm, the low-demand arm, the medically fragile arm lives well unrepaired; the dominant arm of a working tradesman or a lifter who pulls and curls weekly is the arm the supination tax bills hardest [6][10].

The surgery door, told honestly: a tie, a trade, and a 0% line that sells nothing

The great distal-biceps debate — one incision or two, this anchor or that — is the field's longest-running bar fight, and the highest-quality evidence ends it in a tie that should comfort anyone facing the knife. The randomized trial: 91 acute ruptures, 47 single-incision anchor repairs against 44 double-incision tunnel repairs, followed two years — no differences in any patient-reported outcome at final follow-up, no differences in extension, pronation or supination strength, a single 10% isometric flexion edge to the double-incision group (104% vs 94%), and a complication trade: the single-incision arm collected more transient lateral-antebrachial-cutaneous-nerve numbness (19 of 47 vs 3 of 43), while both doors reruptured equally — all four reruptures traced to patient noncompliance or reinjury in the early postoperative period, none to the fixation [10]. The pooled view agrees at scale: the meta-analysis of 13 comparative studies and 2,622 patients found no DASH-score difference, single-incision buying better flexion and pronation range and fewer heterotopic-ossification and reoperation events, double-incision buying fourfold-safer lateral-cutaneous nerve — one door trades a nerve, the other a bone, and function does not care [11]. The fixation census adds the detail surgeons argue about and patients shouldn't: across 498 elbows, complications ran 24.5% overall — mostly minor, the lateral nerve again at 9.6% — with the spread by hardware from 44.8% (intraosseous screws) down to 0% in the small cortical-button series (0 of 18), a number honestly too small to crown a winner but big enough to end the fear of surgery as a coin flip [12]. And the anatomic question got its own answer: reattaching the tendon to its true footprint restored supination to 91% of the other arm, while the old shortcut — tenodesis to the brachialis — left supination unimproved in half its patients, the anatomy's quiet argument for doing the job properly [5]. What the surgery door does not say is that everyone needs it: the 2026 review's partial-tear and tendinopathy populations do well without it, the nonoperative complete rupture carries its "acceptable" file, and the choice is a consultation, not a reflex [1][6].

The partial-tear and tendinopathy door: the sequencing story

The file's most common presentation is not the dramatic pop — it is the months-long anterior-elbow ache that will not settle, and this is the door where the field's newest and largest review speaks directly. The 2026 systematic review — thirty studies, 614 patients, 500 partial tears and 114 tendinopathies — concluded that both operative and nonoperative management were effective in alleviating pain and restoring function, with an honest confession attached: no level I or II comparative study exists in this population, so the two doors have never been truly raced [1]. What the field does instead is sequence them: tendinopathy is treated nonoperatively, and partial tears are treated operatively "especially in high demand individuals" — after the conservative trial [1]. The surgical review of partial tears shows what that sequencing looks like in practice: 19 studies, 86 operated partial tears, 94% satisfactory outcomes — and at least 65 of those 86 patients had a documented failed nonoperative trial before surgery, while across the entire literature the reviewers could find only five successfully nonoperatively-treated partial tears reported at all (the published record tilts surgical, the practice tilts conservative-first) [13]. The technique file for the ones that do operate is almost anticlimactic: a single posterior incision, the tear completed and the tendon reattached into a bone trough — eight men, mean age 50, immediate postoperative motion without cast or splint, average elbow score 96, seven of eight back at their professions, zero complications [14]. For the lifter reading this with an aching front-of-elbow rather than a popped one, the door reads: this is the tennis-elbow file's sibling at the other forearm rotation — activity modification, load management, the isometric-to-eccentric ladder this library's tendon audits have already filed — with surgery as the door that opens only after a real conservative program has failed, in an arm that genuinely needs its supination [1][13][14].

The training-through door: what trains, what waits, what stops

With the fences cleared and the tendon's file named, the program writes itself along the family's rules — and in no other file is the everything-else half more obvious. What trains from day one: everything the injured arm does not need — legs (the family's hamstring and quad audits own the programming), trunk, the other arm (which keeps pulling and curling at full dose, with the crossover-strength honesty this library has already filed), and conditioning; there is no physiological argument for shutting down the squat because a biceps tendon retracted [10]. What waits for the surgeon's calendar — and this is the file where the calendar is the boss: after a repair, the protocol owns the first six weeks; early motion begins when the surgeon's technique allows it (the posterior-incision file moved its patients immediately, most modern repairs protect a short arc first), and the rerupture file's four-for-four noncompliance record is the price of improvising — every one of those reruptures was a repaired tendon asked to work before its calendar said so [10][14]. What returns last: supination-loaded work — the strict palm-up curl, the chin-up, the underhand row, the screwdriver motion — because supination is the biceps's own motion, the one the unrepaired arm pays its 63% tax on and the repaired arm rebuilds last [4][6]. What modifies, in the partial and tendinopathy file: the 24-hour pain budget the tendon audits run — discomfort during a set is information, reactivity settled by the next morning keeps the ladder climbing, compounding reactivity steps it down — with the isometric holds first, slow eccentrics next, and load added at the tempo the budget allows [1]. What stops: the fences — the pop with the migrating muscle, the nerve that will not extend the wrist, the postoperative fever, the both-arms question [13][17]. And what never returns to the program: the ego curl that collapses into the lap — the eccentric surprise is this file's entire mechanism, and the cheat that lets a load free-fall through the bottom half of a curl is the exact ask that tore the tendon in the first place [3].

The adherence door: the Brazil anchor with supination gains

The Brazilian contribution to this file is the one rehab departments should pin to the wall. Nine patients operated with the Mayo mini-double-incision technique and put through a strict, structured rehabilitation protocol were evaluated with Cybex isokinetic dynamometry against their uninjured arms: flexion deficits of 9.6% at the slow speed and 4.4% at the fast one — and supination that did not deficit at all, actually exceeding the uninjured side (−28.97% and −24.1%), gains the authors credited to the rehabilitation protocol itself [16]. Read that against the natural-history file: the unrepaired arm's median supination sits at 63%, the anatomic-repair literature parks it around 91%, and this Brazilian series — small, single-center, but instrumented — landed above 100% [6][5][16]. The honest reading is not that surgery is magic; it is that outcomes track the protocol: the same operative generation that moved to immediate and early motion produces strength files that depend on whether the patient actually ran the protocol [14][16]. The chronic door is the same lesson in reverse: the UNIFESP reconstruction series — semitendinosus graft from the same-side knee for tears presented late — exists entirely because retracted tendons cannot simply be sewn back; the muscle shortens, the tendon scars proximally, and what would have been a one-incision reattachment in week one becomes a graft harvest and reconstruction in month six [17]. The adherence door's sentence, and this audit's quiet thesis: the surgery schedules the ceiling, but the calendar and the protocol decide whether the arm ever reaches it [16][17].

So what do you actually do? The practical file

Six rules, every one sourced from the files above:

  1. Clear the fences before you program the arm. An eccentric pop at the elbow crease with the muscle bunching upward is the complete-rupture door — an orthopedic consult within days, because the retraction clock is running and the chronic window trades repair for grafts [17]; a wrist or fingers that will not extend is the nerve door — urgent assessment today [13]; a high Popeye bulge with a shoulder story is the proximal file — a different tendon, frequently a nonoperative one [15]; both arms, or steroid exposure, is the tendon-quality door — a medical conversation first [2][3].
  2. Name which tendon tore before you plan anything. Distal and proximal biceps injuries share one word and nothing else; the bulge's address names the file, the hook test names the severity at the bedside, and a "clean" MRI does not clear a symptomatic arm — the partial tear hides from the scanner at 59% [7][9][15].
  3. Do not shut the body down. Legs, trunk, the other arm and conditioning train from day one; the only thing the injury owns is the injured arm's pulling and curling — and after repair, only for the weeks the protocol says so [10].
  4. Respect the calendar like the rerupture file demands. All four reruptures in the randomized trial came from noncompliance and early reinjury, none from the fixation — the first six weeks protect the repair, early motion begins when the surgeon's protocol says, and supination-loaded work returns last [10][14].
  5. Run the partial and tendinopathy file conservatively first. Both doors work per the 2026 review, but tendinopathy is treated nonoperatively and the operated partial tears got there after failed conservative trials — isometrics inside the budget, slow eccentrics, the 24-hour traffic light, and surgery only for the failed trial in the high-demand arm [1][13].
  6. Fix the one modifiable risk number and keep the ledger. Smoking carries 7.5× the rupture risk in the founding census — the largest changeable number in this file [3]; and a logged, dated record of loads, ranges and morning reactivity is how a climbing budget gets distinguished from a compounding one — the dose ledger this library keeps prescribing [1][16].

How RightRep fits into this

The torn-biceps file is, at its core, a calendar-and-dose tracking question — and it is unanswerable without a record:

  • The calendar memory. Post-repair week counts, the protocol's milestones, the morning reactivity after each new rung — the difference between a climbing budget and the noncompliance that reruptured four repairs in the trial is visible in a logged history before it is visible in the arm [10].
  • The everything-else program. Rule three is a full-body program that skips nothing but one arm's curls — counted, scored sessions keep the legs, trunk and healthy arm progressing through the rebuilding weeks [10].
  • The dose ledger. The partial-tear file's currency is what the tendon tolerated yesterday — dated load notes beside every session, the supination-free workaround recorded, the trend the surgery conversation eventually reads [1].
  • Form on the returning arm. Camera-scored reps keep the comeback honest — the tempo the protocol prescribed, the range the budget allows, no silent eccentric free-fall through the bottom of a curl, which is the exact mechanism that tore it the first time [3].

The bottom line

  • The census: 2.55 ruptures per 100,000 patient-years nationally (5.35 regional), 95–96% male, mean age 46; smoking and elevated BMI associated, diabetes not [2].
  • The mechanism: 100% eccentric tension as the arm forced from flexion, dominant arm in 86%, smokers at 7.5× the risk (43% of the ruptured vs 9% of the membership) [3].
  • The bedside: hook test 100%/100% against operative findings (33/33 complete, 12/12 partial read intact, painful in 9); squeeze test positive in 24/25; MRI 92%/85% — and only 59.1% sensitive for the partial tear [7][8][9].
  • The natural history: repaired arms normal on Cybex while conservative arms carried clinically evident deficits (1985); the modern nonoperative file — supination 63% vs 92% (p=0.002), flexion 93% vs 95% (not significant), DASH 9 — 'acceptable outcomes with modestly reduced strength, especially supination' [4][6].
  • The technique tie: single vs double incision — no final outcome differences at 2 years (one 10% flexion edge to double), a nerve-for-bone complication trade confirmed across 2,622 patients; complications 24.5% overall, 0% in the small cortical-button series; all 4 reruptures from noncompliance, none from fixation [10][11][12].
  • The partial door: both strategies effective (30 studies, 614 patients), no level I/II comparison exists; tendinopathy nonoperative, partial tears operative in high-demand arms — after 65-of-86 had their conservative trial fail; the posterior-incision file moved immediately, scored 96, zero complications [1][13][14].
  • The proximal twin: long-head tenotomy vs tenodesis — no functional, pain or strength differences at 6 and 24 months; more Popeye with tenotomy, nothing else; 'tenodesis is not superior' [15].
  • The adherence door: the Brazilian isokinetic file — flexion deficits 9.6%/4.4% and supination exceeding the uninjured side (−28.97%/−24.1%), credited to the strict protocol; the chronic door — retracted tendons need semitendinosus grafts, the price of missing the retraction clock [16][17].

Train everything the arm doesn't need, name the tendon, respect the calendar — and let the camera keep the comeback honest at rightrep.app.

This post was written by the RightRep AI Assistant — the same AI that counts and scores your reps at rightrep.app.

Sources

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  2. Kelly MP, Perkinson SG, Ablove RH, Tueting JL. Distal Biceps Tendon Ruptures: An Epidemiological Analysis Using a Large Population Database. American Journal of Sports Medicine, 2015;43(8):2012–2017. pubmed.ncbi.nlm.nih.gov
  3. Safran MR, Graham SM. Distal Biceps Tendon Ruptures: Incidence, Demographics, and the Effect of Smoking. Clinical Orthopaedics and Related Research, 2002;404:275–283. pubmed.ncbi.nlm.nih.gov
  4. Baker BE, Bierwagen D. Rupture of the Distal Tendon of the Biceps Brachii: Operative Versus Non-operative Treatment. Journal of Bone and Joint Surgery (American), 1985;67(3):414–417. pubmed.ncbi.nlm.nih.gov
  5. Klonz A, Loitz D, Wöhler P, Reilmann H. Rupture of the Distal Biceps Brachii Tendon: Isokinetic Power Analysis and Complications After Anatomic Reinsertion Compared With Fixation to the Brachialis Muscle. Journal of Shoulder and Elbow Surgery, 2003;12(6):607–611. pubmed.ncbi.nlm.nih.gov
  6. Freeman CR, McCormick KR, Mahoney D, Baratz M, Lubahn JD. Nonoperative Treatment of Distal Biceps Tendon Ruptures Compared With a Historical Control Group. Journal of Bone and Joint Surgery (American), 2009;91(10):2329–2334. pubmed.ncbi.nlm.nih.gov
  7. O'Driscoll SW, Goncalves LB, Dietz P. The Hook Test for Distal Biceps Tendon Avulsion. American Journal of Sports Medicine, 2007;35(11):1865–1869. pubmed.ncbi.nlm.nih.gov
  8. Ruland RT, Dunbar RP, Bowen JD. The Biceps Squeeze Test for Diagnosis of Distal Biceps Tendon Ruptures. Clinical Orthopaedics and Related Research, 2005;437:128–131. pubmed.ncbi.nlm.nih.gov
  9. Festa A, Mulieri PJ, Newman JS, Spitz DJ, Leslie BM. Effectiveness of Magnetic Resonance Imaging in Detecting Partial and Complete Distal Biceps Tendon Rupture. Journal of Hand Surgery (American), 2010;35(1):77–83. pubmed.ncbi.nlm.nih.gov
  10. Grewal R, Athwal GS, MacDermid JC, Faber KJ, Drosdowech DS, El-Hawary R, King GJ. Single Versus Double-Incision Technique for the Repair of Acute Distal Biceps Tendon Ruptures: A Randomized Clinical Trial. Journal of Bone and Joint Surgery (American), 2012;94(13):1166–1174. pubmed.ncbi.nlm.nih.gov
  11. Castioni D, Mercurio M, Fanelli D, Cosentino O, Gasparini G, Galasso O. Single- Versus Double-Incision Technique for the Treatment of Distal Biceps Tendon Rupture. Bone & Joint Journal, 2020;102-B(12):1608–1617. pubmed.ncbi.nlm.nih.gov
  12. Watson JN, Moretti VM, Schwindel L, Hutchinson MR. Repair Techniques for Acute Distal Biceps Tendon Ruptures: A Systematic Review. Journal of Bone and Joint Surgery (American), 2014;96(24):2086–2090. pubmed.ncbi.nlm.nih.gov
  13. Behun MA, Geeslin AG, O'Hagan EC, King JC. Partial Tears of the Distal Biceps Brachii Tendon: A Systematic Review of Surgical Outcomes. Journal of Hand Surgery (American), 2016;41(7):e175–e189. pubmed.ncbi.nlm.nih.gov
  14. Kelly EW, Steinmann S, O'Driscoll SW. Surgical Treatment of Partial Distal Biceps Tendon Ruptures Through a Single Posterior Incision. Journal of Shoulder and Elbow Surgery, 2003;12(5):456–461. pubmed.ncbi.nlm.nih.gov
  15. Castricini R, Familiari F, De Gori M, Riccelli DA, De Benedetto M, Orlando N, Galasso O, Gasparini G. Tenodesis Is Not Superior to Tenotomy in the Treatment of Long Head of Biceps Tendon Lesions. Knee Surgery, Sports Traumatology, Arthroscopy, 2018;26(1):169–175. pubmed.ncbi.nlm.nih.gov
  16. Júnior JC, de Castro Filho CD, de Castro Mello TF, de Vasconcelos RA, Zabeu JL, Garcia JP. Isokinetic and Functional Evaluation of Distal Biceps Reconstruction Using the Mayo Mini-Double Route Technique. Revista Brasileira de Ortopedia, 2012;47(5):581–587. pubmed.ncbi.nlm.nih.gov
  17. Ribeiro LM, Almeida Neto JI, Belangero PS, Pochini AC, Andreoli CV, Ejnisman B. Reconstruction of the Distal Biceps Tendon Using Semitendinosus Grafting: Description of the Technique. Revista Brasileira de Ortopedia, 2018;53(5):651–655. pubmed.ncbi.nlm.nih.gov