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Tendinopathy Rupture [2] [3] [4] Acute, high-impact trauma in healthy tendons (e.g., heavy lifting, fall on outstretched hand) Minor trauma in bicep tendon weakened by tendinopathy Medications: fluoroquinolones, corticosteroids [2] Tobacco use Shared risk factors [1] Microtrauma caused by repetitive overhead movement (e.g., sports, manual labor) [2] Age-related degeneration [1] Pre-existing shoulder pathology