A Pull, a Pop, a Biceps Knot – You’ve Got a “Popeye Arm”

A biceps tendon tear may have a funny nickname, but it’s no joke.

Popeye got his by sucking down a can of spinach. And that was a good thing.

For the rest of us, it’s just the opposite.

The cartoon sailor man’s namesake malady – the “Popeye arm” or “Popeye deformity” – causes weakness, sharp pain, and may require surgery to repair. Whether you eat spinach or not.

Technically, it’s known as a biceps tendon tear or rupture. The nickname comes from the distinctive lump bulging prominently on your upper arm. Basically, it looks like a knot the size of a baseball (or golf ball, depending on how big that baby was to start with) somewhere north or south of where your biceps normally resides.

Only, instead of being big and strong and ready to battle Bluto, it tends to be more pillowy. Because, where your biceps is normally strung taut by the tendons like a hammock between two trees, when it tears it can wind up swinging free. And like that hammock, when one end breaks loose – Plop!

Depends which end

“When you tear it down at the elbow it leads to more weakness,” says Dr. Michael Baraga, a sports medicine specialist and orthopedic surgeon with the University of Miami Sports Medicine Institute. “That’s generally a more urgent surgical indication because you can expect about 30 percent loss of strength and bending of your elbow.”

A tear at the shoulder, he says, “catches a lot of people by surprise.”

That’s because the pain can go away, leading people to think it was nothing … except for that lingering lump.

Weighty matters

It usually happens from lifting too much too suddenly. Whether it’s weights or that box of junk in the garage you jerked up off the ground, that yank can tear the tendon that connects your guns to the bones.

The tell-tale signs are:

• A nasty bruise on the upper arm near the elbow
• Difficulty turning your arm from palm down to palm up
• Hearing and/or feeling a “pop” when it first happens
• Sudden, intense pain by the shoulder or elbow
• Weakness in the affected arm

Take it easier

Sometimes, the repeated strains of overuse can inflame the tendons, causing them to degenerate, and making them more prone to tearing and rupturing. Time takes a toll, too. Tendons and ligaments can weaken with wear. But younger athletes – serious golfers and tennis players – may suffer tears, as well.

So, to help avoid a tear, don’t overdo it. If you’re starting a weightlifting or CrossFit program, for example, ease into it.

And pay attention to your body’s warning signs. Soreness is normal. Pain is not. Neither is soreness that doesn’t go away after a couple of days of rest.

Tear repairs

If you do tear a tendon, you’ll want expert help. Proper rehab and recovery, including physical therapy, might repair the damage caused by Popeye arm. John Elway, the former Denver Broncos QB tore his at the shoulder and came back to win two Super Bowls. Without an operation.

That kind, known as a proximal tendon rupture, accounts for the vast majority of biceps tendon tears. And, says Dr. Thomas Best, a family medicine-sports medicine specialist with the University of Miami Sports Medicine Institute and team physician for the Miami Marlins, usually doesn’t call for a trip to the OR.

“Nine times out of 10, we’re not going to do anything more than potentially offer you a little bit of physical therapy,” he says.

Tears at the elbow, known as distal tendon ruptures, are another story. A surgeon may have to go in, find the tendon, and reattach it.

Time is of the essence. Surgery works best within two weeks of the injury. After that, both the tendon and the biceps muscle start to scar and shorten, complicating both the surgery and the outcome.

Carlos Harrison is a contributing writer for UMiami Health News

Tags: bicep tear, Dr. Michael Baraga, Dr. Thomas Best, physical therapy, sports injury, tendon rupture, University of Miami Sports Medicine Institute