{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:10:18Z","timestamp":1756379418098,"version":"3.44.0"},"reference-count":31,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,28]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>A 34-year-old man, with previous anabolic steroid abuse, presented with right shoulder pain following an underhand bowling swing. Examination indicated a Popeye sign of the right biceps, and positive Speeds, Yergason and O\u2019Brian\u2019s tests. MRI indicated a complete tear of the intra-articular portion of the long head of biceps tendon (LHBT). Interestingly, the tear occurred within the glenohumeral joint allowing the proximal portion of the LHBT to uniquely coil and fold on itself deep to the subscapularis causing mechanical symptoms. He was treated conservatively with physical therapy but failed to achieve pain relief and proceeded with arthroscopic debridement of the folded portion of the LHBT stump, which significantly improved clinical outcomes at 18\u2009months postoperative. We report the first case of an LHBT tear during bowling in a young adult with a rare occurrence of the proximal portion of the LHBT uniquely coiling and folding on itself deep to the subscapularis.<\/jats:p>","DOI":"10.1136\/bcr-2019-232936","type":"journal-article","created":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T04:19:15Z","timestamp":1578889155000},"page":"e232936","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Atypical tear of the long head of the biceps tendon in a young male adult"],"prefix":"10.1136","volume":"13","author":[{"given":"Prabjit","family":"Ajrawat","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Etobicoke General Hospital, Etobicoke, Ontario, Canada"},{"name":"Division of Orthopaedic Surgery, Toronto Western Hospital, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deven","family":"Bhargava","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Etobicoke General Hospital, Etobicoke, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Sadoughi","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Etobicoke General Hospital, Etobicoke, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,1,12]]},"reference":[{"key":"2025082803293061000_13.1.e232936.1","first-page":"204","article-title":"Lesions of the long head of the biceps tendon","volume":"34","author":"Warren","year":"1985","journal-title":"Instr Course Lect"},{"key":"2025082803293061000_13.1.e232936.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(05)80035-7"},{"key":"2025082803293061000_13.1.e232936.3","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1016\/j.arthro.2017.10.050","article-title":"Proximal long head biceps rupture: a predictor of rotator cuff pathology","volume":"34","author":"Kowalczuk","year":"2018","journal-title":"Arthroscopy"},{"key":"2025082803293061000_13.1.e232936.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2004.03.003"},{"key":"2025082803293061000_13.1.e232936.5","doi-asserted-by":"crossref","DOI":"10.1136\/bjsm.2006.031708","article-title":"Proximal biceps rupture: management of an unusual injury in an arm wrestler","volume":"41","author":"Pratt","year":"2007","journal-title":"Br J Sports Med"},{"key":"2025082803293061000_13.1.e232936.6","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1016\/j.jse.2008.04.006","article-title":"A long-head of biceps tendon rupture in a fast pitch softball player: a case report","volume":"18","author":"Ferry","year":"2009","journal-title":"J Shoulder Elbow Surg"},{"key":"2025082803293061000_13.1.e232936.7","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jotr.2013.05.012","article-title":"Unusual complete proximal biceps tendon rupture","volume":"17","author":"Abdullah","year":"2013","journal-title":"J Orthop Trauma Rehabiliation"},{"key":"2025082803293061000_13.1.e232936.8","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2014.4893"},{"key":"2025082803293061000_13.1.e232936.9","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jse.2016.06.007","article-title":"Determining the minimal clinically important difference for the American shoulder and elbow surgeons score, simple shoulder test, and visual analog scale (vas) measuring pain after shoulder arthroplasty","volume":"26","author":"Tashjian","year":"2017","journal-title":"J Shoulder Elbow Surg"},{"key":"2025082803293061000_13.1.e232936.10","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2009.2802"},{"key":"2025082803293061000_13.1.e232936.11","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1302\/0301-620X.76B6.7983126","article-title":"The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders","volume":"76-B","author":"Vangsness","year":"1994","journal-title":"J Bone Joint Surg Br"},{"key":"2025082803293061000_13.1.e232936.12","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.89B8.19278"},{"key":"2025082803293061000_13.1.e232936.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.03.006"},{"key":"2025082803293061000_13.1.e232936.14","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1384-x"},{"key":"2025082803293061000_13.1.e232936.15","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/BF00266702","article-title":"Tendon injuries induced by exercise and anabolic steroids in experimental mice","volume":"11","author":"Michna","year":"1987","journal-title":"Int Orthop"},{"key":"2025082803293061000_13.1.e232936.16","doi-asserted-by":"crossref","first-page":"411","DOI":"10.2106\/00004623-199274030-00013","article-title":"The effect of anabolic steroids on the biomechanical and histological properties of rat tendon","volume":"74","author":"Miles","year":"1992","journal-title":"J Bone Joint Surg Am"},{"key":"2025082803293061000_13.1.e232936.17","doi-asserted-by":"publisher","DOI":"10.1177\/036354658801600211"},{"key":"2025082803293061000_13.1.e232936.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2005.04218.x"},{"key":"2025082803293061000_13.1.e232936.19","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515602010"},{"key":"2025082803293061000_13.1.e232936.20","doi-asserted-by":"crossref","first-page":"366","DOI":"10.2106\/00004623-199503000-00006","article-title":"The role of the long head of the biceps brachii in superior stability of the glenohumeral joint","volume":"77","author":"Warner","year":"1995","journal-title":"J Bone Joint Surg Am"},{"key":"2025082803293061000_13.1.e232936.21","doi-asserted-by":"crossref","unstructured":"Kumar VP , Satku K , Balasubramaniam P . The role of the long head of biceps brachii in the stabilization of the head of the humerus. Clin Orthop Relat Res 1989:172\u20135.doi:10.1097\/00003086-198907000-00015","DOI":"10.1097\/00003086-198907000-00015"},{"key":"2025082803293061000_13.1.e232936.22","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508328105"},{"key":"2025082803293061000_13.1.e232936.23","doi-asserted-by":"publisher","DOI":"10.1067\/mse.2001.114259"},{"key":"2025082803293061000_13.1.e232936.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(03)00093-2"},{"key":"2025082803293061000_13.1.e232936.25","doi-asserted-by":"crossref","DOI":"10.1177\/2325967115570848","article-title":"Biceps tenotomy versus Tenodesis in active patients younger than 55 years: is there a difference in strength and outcomes?","volume":"3","author":"Friedman","year":"2015","journal-title":"Orthop J Sports Med"},{"key":"2025082803293061000_13.1.e232936.26","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2001.24852"},{"key":"2025082803293061000_13.1.e232936.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2004.01.008"},{"key":"2025082803293061000_13.1.e232936.28","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091066"},{"key":"2025082803293061000_13.1.e232936.29","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.arthro.2007.11.017","article-title":"A new slap test: the supine flexion resistance test","volume":"24","author":"Ebinger","year":"2008","journal-title":"Arthroscopy"},{"key":"2025082803293061000_13.1.e232936.30","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507305016"},{"key":"2025082803293061000_13.1.e232936.31","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2003.50104"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232936","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:29:44Z","timestamp":1756376984000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232936"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,12]]},"published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1136\/bcr-2019-232936"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232936","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}