“…If they are not fixed acutely, distal bicep ruptures lead to decreased supination strength, fatigue, and an identifiable 'reverse Popeye sign' caused by proximal retraction of the tendon stump with 30 and 40% reductions in flexion and supination strength, respectively. As a result, in the healthy, active patient population, primary repair of acute distal biceps ruptures is indicated to restore flexion and supination strength as well as maintain elbow range of motion (ROM) [9][10][11].…”