Biceps Squeeze Test | Distal Biceps Tendon Rupture Assessment

On our website, you can find the Thompson test also known as the calf squeeze test which is a popular test for Achilles tendon ruptures. In an intact tendon, squeezing the calf should initiate ankle plantar flexion.

Similarly, Ruland et al. (2005) hypothesized that a comparable mechanism could be observed with the biceps and its distal tendon.

In their study, they report a sensitivity of 96% but specificity cannot reliably be noted due to the small sample of patients with a negative response. The study lacks methodological items which is why we attribute a weak clinical value to this test.

To conduct the test, the patient will be in sitting position and you’re going to stand next to the affected arm.

With the forearm resting on the thighs the elbow is flexed to around 60-80 degrees to minimize tension in the brachialis and to isolate the biceps to forearm supination.

Proceed by slightly pronating the forearm to place tension on the biceps tendon. Then grasp the muscle with both hands placed at the distal myotendinous junction and the muscle belly and squeeze it firmly.

The test is considered positive for a distal biceps tendon rupture if forearm supination cannot be observed.

Other common orthopedic tests to assess for distal biceps tendon ruptures are:

• Ludington’s Test
• Hook Test
• Supination Pronation Test
• Tilt Sign
• Biceps Crease Interval

Ruland, C. R. T., & Bowen, C. J. D. (2005). The biceps squeeze test for diagnosis of distal biceps tendon ruptures. Clinical Orthopaedics and Related Research®, 437, 128-131.