Ruland Biceps Squeeze Test

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 Ruland Biceps Squeeze Test

What is Ruland Biceps Squeeze Test?

Ruland Biceps Squeeze Test is used to check for distal biceps tendon avulsion. This test is similar to Thompson Test that is used in Achilles tendon rupture.

Biceps Squeeze Test was developed by Robert T Ruland in 20051.

How Ruland Biceps Squeeze Test is performed?

Ruland Biceps Squeeze Test
Ruland Biceps Squeeze Test

What does a positive Ruland Biceps Squeeze Test mean?

Sensitivity & Specificity

A study by Ruland1 to evaluate biceps Squeeze Test for diagnosis of distal biceps tendon ruptures, he found that this test has a high Sensitivity & Specificity in diagnostic distal biceps tendon injury:

Related Anatomy

distal biceps tendon anatomy
Distal biceps tendon anatomy

Biceps Tendon Rupture

Biceps Tendon Rupture Symptoms:

The typical history includes a report of a sharp, tearing pain concurrent with an acute injury in the antecubital fossa.

Clinical findings vary depending on the extent of the rupture; whether it is partial or complete.

The objective findings may include:

  1. Ecchymosis in the antecubital fossa,
  2. A palpable defect of the distal biceps,
  3. Loss of strength of elbow flexion and grip, but especially a loss of forearm supination strength.

In active individuals, the normal recommendation is primary repair of the acute tendon avulsion. If not repaired, a 30% loss of elbow flexion and a 40% loss of supination strength can be expected2.

Postoperatively, the elbow is protected for 6–8 weeks, after which unrestricted range of motion and gentle strengthening exercises are initiated. Return to unrestricted activity is usually not allowed until nearly 6 months of healing has passed.

distal biceps tendon avulsion
Distal biceps tendon avulsion


  1. RT Ruland, Robert P Dunbar, JD Bowen: The biceps Squeeze Test for diagnosis of distal biceps tendon ruptures. August 2005, Clinical Orthopaedics and Related Research. Link
  2. Morrey BF, Askew LJ, An KN, et al: Rupture of the distal tendon of the biceps brachii: a biomechanical study. J Bone Joint Surg 67A:418–421, 1985.
  3. Hempel K, Schwencke K: About avulsions of the distal insertion of the biceps brachii tendon. Arch Orthop Unfallchir 79:313–319, 1974.
  4. McReynolds IS: Avulsion of the insertion of the biceps brachii tendon and its surgical treatment. J Bone Joint Surg 45A:1780–1781, 1963.
  5. Mark Dutton, Pt . Dutton’s Orthopaedic Examination, Evaluation, And Intervention, 3rd Edition Book.
  6. Millers Review of Orthopaedics, 7th Edition Book.

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