Complete Intrasubstance Rupture of the Biceps Brachii Via Atypical Eccentric Contraction: A Case Report

CASE A 46-year-old man presented with extensive swelling and ecchymosis of the arm and antecubital fossa after a 4-foot fall from a ladder in which he attempted to arrest his decent by grabbing onto a wooden ceiling beam. Ultrasound and magnetic resonance imaging confirmed a complete intrasubstance rupture of the biceps brachii. Nonoperative management was recommended and, at 9-week follow-up, the patient had resumed light weightlifting and demonstrated painless full active range of motion. CONCLUSIONS Uncommon complete intrasubstance biceps brachii ruptures can occur via an atypical mechanism of isotonic eccentric muscle contraction and satisfactory results may be realized through nonoperative management.