Understanding Biceps Tears in Baseball: Causes, Symptoms, and Injury Rehab

Biceps tears can happen several different ways in baseball. Although these tears most commonly occur at the shoulder during the act of pitching — due to repeated bouts of stressful muscular overload across the phases of throwing — they can occur at both the origin (start) and insertion (finish) points of the muscle. 

How do the biceps become overloaded at the elbow? Simply put… eccentric overload.

Eccentric overload occurs when the external force is greater than the force needed/used to complete a movement; usually occurring in gym settings where an individual is attempting to curl too much or flip a giant tire. On Apr. 8, 2025, Seattle Mariners rookie 2B, Ryan Bliss unfortunately experienced just that. In the 2nd inning of the game, he took a big swing on a breaking ball; whiffing with a one-handed finish dissimilar to his usual swing. As a result, his elbow was suddenly forced into hyperextension; causing an unexpected eccentric overload event.

The split second internal correction to his finish served its purpose in putting his arm back into a stronger slightly bent position. However, the load transferred into his arm had likely already torn his left biceps tendon in the process.

Distal (at the insertion) biceps tears tend to require surgery — with an MRI being the only way to confirm the presence of a tear. In cases that have required surgical repair, position players have an 80% return-to-play success rate. For tears of less than 50%, “cleanups” are typically done and yield a slightly shorter rehab process because of the athlete’s ability to begin range of motion (ROM) exercises while circumventing ≈4-weeks of immobilization. For tears greater than 50%, surgical reattachment is the usually the call; with ROM exercises beginning 4-6 weeks post-op and traditional rehab running for another 12 weeks — matching the Mariners medical team’s 4-5 month (16-20 weeks) recovery timeline. 

Good news is that this isn’t the first notable distal biceps tear to draw from. Mo Vaughn (2001) and Miguel Cabrera (2018) suffered similar injuries — Cabrera almost identically — and through injury rehab they returned to play at their previously elite levels. 

Good luck Mr. Bliss. 

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