Biceps tendonitis is the inflammation or irritation of the biceps tendon, which connects the biceps muscle to the shoulder. The biceps muscle is the large muscle in the front area of the upper arm. This muscle is connected to the bones above and below the arm by a thick strong tendon. Tendons are strong cord-like structures connecting each end of the biceps muscle to bones. At one end of the biceps muscle, tendons connect the biceps to the shoulder in two places. At the other end of the muscle, tendons connect the biceps muscle to the smaller bone (radius) in the lower arm. There are two heads to the biceps muscle, the long head and the short head.
The biceps muscle assists to stabilize the large bone in the upper arm (humerus) in the shoulder socket. The biceps muscle also helps to accelerate and decelerate the arm during overhead activities, like tennis or pitching.
Causes of biceps tendonitis:
With repetitive use, the biceps tendon can become inflamed resulting in tendonitis. Injuries to the biceps tendons are often caused by repetitive overhead activity. Overuse, aging, and stress can cause the tendon to deteriorate, even if there is no inflammation present.
Symptoms of Biceps tendonitis:
Painful sensation at the upper shoulder that occurs with movement of the arm.
Localized tenderness as the tendon passes over the groove in the upper arm bone.
Occasionally, a snapping sound or sensation in the shoulder area.
Pain may get worse by lifting, overhead reaching, or both. Inflammation that persists increases the risk of rupturing (tearing) of a biceps tendon. In people whose biceps’ tendon ruptures, a lump can be seen and felt in the lower biceps muscle. Shoulder pain due to bicipital tendonitis is sometimes completely relieved after the rupture occurs.
Diagnosis:
Biceps tendonitis is usually diagnosed based on the patient’s history and description of pain as well as the results of a physical examination. In the physical exam, the clinician assesses the patient\'s pain while moving the affected arm through a series of motions. This assessment helps the clinician confirm the diagnosis and evaluate the severity of the condition. Sometimes, the doctor may want to use X-rays or magnetic resonance imaging (MRI) to look inside the joint for other conditions or tendon injuries that might cause the pain.
Treatment:
Treatment options for biceps tendonitis include:
Ice packs to the affected area
Anti-inflammatory medication
Rehabilitation exercises
Steroid injections
Treatment of biceps tendonitis focuses on reducing tendon inflammation and swelling, strengthening the biceps muscle and tendon, and preventing rupture. Initial treatment includes application of ice for 15 to 20 minutes each day to reduce inflammation. If needed, a pain killer can be taken.
Elimination of lifting and restrictions on over-the-shoulder positions should be followed until the symptoms have resolved. It is safest to keep the arm down and in front of and close to the body. One should lift objects close to the body and lift light weights and below shoulder level. Also eliminate over arm movements and maintain good posture with writing, working, etc.
Stretching exercise should be performed for five to ten minutes a day during the first few weeks of recovery; these exercises are intended to help maintain joint mobility and flexibility of the muscles and tendons in the shoulder. Range of motion/flexibility exercises should not cause more than a mild level of pain; patients who feel sharp or tearing pain while stretching should stop exercising immediately and consult with their healthcare provider.
Toning exercises should begin three to four weeks after the initial pain has resolved. Daily toning exercises are particularly important for patients who have had a tendon rupture.
If symptoms persist for more than four weeks despite treatment, a steroid may be injected into the affected area to reduce inflammation.
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