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Causes for a proximal biceps tendon tear include: Falling on an outstretched arm Lifting very heavy objects Excessive use of the shoulder during sports and overhead activities The risk factors for developing a proximal biceps tendon tear include: Aging Smoking Use of certain medications Symptoms of a Proximal Biceps Tendon Tear You may experience one or more of the following symptoms: Sudden, sharp shoulder or upper arm pain Snapping sound or pop in the shoulder or upper arm region Tenderness at the shoulder Biceps muscle cramping The weakness with shoulder and elbow movements Difficulty rotating the forearm Diagnosis of a Proximal Biceps Tendon Tear Your doctor will look for specific signs such as the Popeye Muscle sign where the biceps muscle bunches up near the elbow which implies a complete rupture of the proximal tendon