A 51-year-old man suffered a rupture of the long-head tendon of the left bi
ceps and a small rotator cuff tear while rock climbing. The typical signs a
nd symptoms of a ruptured long-head biceps tendon include anterior shoulder
pain, tenderness in the bicipital groove, and unusual bulging of the injur
ed biceps. The history and physical exam are generally sufficient to make t
he diagnosis, but x-rays and MRI may be helpful to rule out related disorde
rs. Because the injury is often associated with rotator cuff tendinitis, a
complete shoulder exam is necessary. Conserative treatment will enable most
patients to regain normal strength.