I’m a mid-50s guy in good shape, especially for my age. I gotta admit I’m doing everything I can to hold off the aging process. There are several other guys like me at the club where I work out and lift weights who ended up tearing their biceps tendon lifting. I don’t want that to happen to me. Is it really age-related or is there something about the way they were lifting that caused the problem?

Biceps tendon ruptures are linked with lifting when there is a sudden eccentric load on the muscle. Eccentric means the muscle was full contracted (arm flexed) and starting to extend. This can occur with weight lifting but also in manual laborers lifting, carrying, and putting down heavy loads.

Men are affected most often though there are some cases reported in women. The average age of these types of biceps ruptures is between 47 and 50 years so there may be some age-related factors. Bilateral (both sides) distal biceps tendon ruptures have also been reported though these injuries don’t usually occur at the same time. There may be a period of months to years between the first arm (biceps) and the second rupturing.

Surgeons think there may be some anatomical reason why the biceps tendons in these patients give way. There may be a load involved but some pathologic change in the tendon puts it at increased risk for injury.

Exactly what that anatomic change may be is still unknown. Some experts suggest an extra lip of bone where the tendon attaches may be the culprit. Or in some people, there may be an area of decreased blood supply just above where the tendon pulls away from the bone. Examination of the torn tissue under a microscope has revealed some degenerative changes in some cases.

Other studies have reported additional risk factors including smoking (nicotine use) and the use of anabolic steroids (illegal use of steroids to bulk up muscles). Whatever the cause, this study confirms it’s more than a coincidence that bilateral distal biceps ruptures occur. Patients who have the first biceps tendon rupture may be at increased risk for injury to the other arm. More study is needed to fully identify predictive risk factors that might help with prevention of these injuries.

In the case of weight lifting and body building for middle-aged adults (and older), it is always advised that you work with someone who fully understands the anatomy and physiology of the aging body. A physical therapist or exercise physiologist is the best person to guide you.