About This Procedure
Biceps and triceps tendon ruptures are significant injuries that rob the arm of strength and function. The biceps muscle has two tendons at the shoulder (proximal) and one at the elbow (distal). The triceps tendon attaches at the elbow. When any of these tendons tear — usually due to a sudden forceful load — prompt evaluation and, in many cases, surgical repair is essential to restoring full strength.
Dr. Jay Levin treats biceps and triceps tendon injuries for patients throughout Durham, Cary, and North Carolina at Duke Health. He tailors the treatment approach to the specific tendon involved, the patient's age and activity goals, and the acuity of the injury.
Distal biceps repairs (at the elbow) are almost always recommended for active individuals because non-operative management leads to permanent strength loss. Proximal biceps tendon problems at the shoulder — including tears and tendinitis — are more nuanced, with decisions ranging from observation to tenodesis (reattachment at a new site) to frank repair. Triceps tendon ruptures, while less common, require surgical reattachment to restore full elbow extension strength.
The Procedure
The approach and technique vary depending on which tendon is being repaired.
For distal biceps repair at the elbow, Dr. Levin uses a small anterior (front-of-elbow) incision to locate the retracted tendon and reattach it to the radial tuberosity using a cortical button or dual-incision suture anchor technique. Both methods provide strong, durable fixation.
For proximal biceps tenodesis at the shoulder, the procedure is often performed arthroscopically or through a small open incision, reattaching the tendon to the upper humerus. This is frequently combined with other shoulder procedures such as rotator cuff repair.
Triceps tendon repair is performed through a posterior (back-of-elbow) incision, reattaching the tendon to the olecranon using suture anchors. All procedures typically take 1–1.5 hours.
Recovery at Duke Health
After biceps or triceps tendon repair, your arm will be placed in a sling or protective brace for 4–6 weeks. This protects the repair during the critical early healing phase when the tendon is most vulnerable to re-rupture.
At 6 weeks, gentle range-of-motion exercises begin. Progressive strengthening follows at 10–12 weeks under the supervision of a Duke Health physical therapist. Patients in Durham and the broader Triangle area benefit from Duke's extensive therapy network and Dr. Levin's close involvement in recovery milestone decisions.
Full return to heavy lifting, manual labor, and overhead sports typically occurs at 5–6 months. Dr. Levin and his team track your progress carefully and adjust your program to optimize both healing and functional recovery.