Rupture of the distal biceps tendon in middle-aged, active individuals can occur after antecedent elbow or forearm pain, leading to a loss of supination strength.

“one of the common ones is the um middle age but very active fit person who maybe had a little antecedent elbow pain or forearm pain they didn't quite know what it was but they did workarounds then they ruptured their distal biceps and so they get a Popeye muscle it's all weird and even quivering and they come in they go oh my God you've got to do something and the cool thing about the bicep we think of the biceps as as being you know we do biceps card it's an elbow flexor but it and it is a secondary elbow flexure but it's the primary supinator of the form so people come in and they lose when they when they tear their biceps they don't lose that much flexion strength but they lose most of their supination strengths”

“but they did workarounds and then they ruptured their distal biceps and so they get a Popeye muscle it's all weird and and even quivering and they come in they go oh my God you've got to do something and um the cool thing about the bicep we think of the biceps as as being you know we do BPS cor it's an elbow flexor but it and and it is a secondary elbow flexor but it's the primary supinator of the forearm so people come in and they lose when they when they tear their biceps they don't lose that much flexion strength but they lose most of their superation strength”