T Nation

Distal Biceps Tendon, Advice/Experience?


Hey. Wondering if anyone has had problems with [Distal Biceps Tendon] ? When doing pullups,curls etc ? I dont seem to have it torn, but I feel some pain sometimes when doing curls, or mostly when doing back workouts, that regquire pulling, pullups mostly. After massaging it it seems better, but anyone have any suggestions how to avoid this ?



The pain means its just pissed off, tearing it (at least a full rupture in my case) had no associated pain at all. Before I ruptured it, both forearms were killing me for months, hurt to pick up my kids. If you’ve done some google research there isnt much out there suprisingly but I found that slow eccentrics/negatives really helped. Started with 5lb dumbell in one hand, lift it with the other hand into curl position, then slowly lower unassisted for 3 or 4 sets of high reps 12-20 as many times a day as possible. Do both pronated and suppinated grips. Increase weight 5 lbs. when it feels comfortable, little to no pain. Luckily I had a set of adjustable DBs at home or I can see how doing this multiple times would be an issue. It takes a while so be patient. Sucks but lay off any pulling that aggravates it, try changing grip. If overhand hurts try neutral or underhand, experiment but dont push it. Once mine were mostly better I went and blew it out doing heavy deadlifts, Im sure it was already weakened.

I dont buy into the RICE recommendations, you’ll stop working out for weeks just to have the pain come right back when you start. Massaging as you mention is great as well to promote blood flow to the area helping with healing. Tendons lack the same bloodflow as muscles so they need extra help there.


Thanks for the info mate!

Massage with other side of a knife worked great for me, took out tension, had a great workout today!

Hope yours is better!


I think you have talked about something that affects most people especially newbies. I also experience the same after going through my reps. But I visited my doctor explained the problem to him and he prescribed some brand of medication which I use and I feel much better. I bet you should see a physician.


Yeah maybe… better be safe


I’m a member of the ‘ruptured biceps tendon s/p surgical repair club’ myself (Class of 2001). Like @roscop12, I had terrible ‘forearm’ pain for years prior to the rupture. (The distal biceps inserts on the forearm deep to the brachioradialis, so many misinterpret the pain as originating from that muscle.) The moment I ruptured the tendon, I realized two things: One, I had been misinterpreting my forearm pain all those years, and Two, that my tendon issues stemmed from a dumb workout routine.

And that’s the part you need to correct right away if you wish to avoid having a lifetime of biceps issues, like me. (I still have pain, mainly on the unruptured side.) Simply put, you’re stressing your biceps tendons too much, either in terms of workload or frequency (or both). If you want, I’ll help you optimize your program to maximize the odds you’ll never have to ‘graduate.’ If interested, post your routine.


I’ll jump in here for some advice. My distal biceps on the left has been painful for about 3 weeks. I can do all back stuff with almost no issues, however any curling movements cause sharp pain. My routine is basically full body lifting 3x/week. So I do some sort of bicep curls 3x/week. I will either do 3-4 sets of one exercise. I’ll rotate between incline dumbbell curls, incline dumbbell hammer curls, cable curls both facing towards and away from the cables. I even throw in a machine curl every now and then. I don’t go super heavy. I will do rest pause or mechanical drops or do isometric holds. I haven’t done any curling since aggravating the tendon. It’s very frustrating! Any thoughts would be appreciated.


How are your shoulders and posture? If you have tight pecs/front shoulders and you’re kinda slumped forward with the arms internally rotated (like knuckles forward) it can put pressure on your biceps. This chronic pressure makes them shorten/tighten and get painful.


No postural issues. I tweaked the left distal biceps doing incline dumbbell curls. I just ignored the problem and kept going. The pain is actually some better with rest. I’m hoping to be able to curl again soon.


Maybe you just beat it up with the stretched, elbow behind the body, incline curl position.

In the future, maybe try some Spider Curls to work on the “top end” of your biceps?


I think you hit it right on the head. I really like the incline dumbbell curls and probably overdid them. I’m hoping to be able to get back to some sort of curling soon. Thanks.


Incline bicep curls are what first aggravated my tendon, leading up to the eventual rupture.


I’ve just ruptured my distal biceps tendon (5 days ago), or at least that is the sports medicine doctor’s opinion after examination as we are still waiting for an ultrasound to be done on it to confirm this diagnosis. That will be done on this Wednesday (Feb. 27) and then I have an appointment with the orthopaedic surgeon the next morning. I’ve read a fair bit online about recovery times and different outcomes for surgical vs. non-surgical management of it. I am a dentist and obviously need 2 functioning arms to work. Luckily, it is my non-dominant (left) arm which, for the most part, I only need to hold the mirror at work. I’ve been able to work quite normally so far since the injury.
My concerns are twofold:
1.) What amount of work would I need to miss after surgery and what does the recovery schedule look like?
2.) What would the strength loss / impairment be in my injured arm compared to the non-injured one especially in relation to weight training for both the surgical and non-surgical treatment options?
Anyone who has any experience with either the surgical vs. the non-surgical treatments for this I would greatly appreciate their input (especially you @EyeDentist as I would really value a medical practitioner’s opinion who himself has undergone this procedure).