Biceps Tendinitis
Biceps tendinitis happens when the upper biceps tendon becomes inflamed. This tendon, which is also called the long head of the biceps, links the biceps muscle to the shoulder blade. The disorder may also affect the elbow.
This overuse injury results from recurrent overhead movements. Athletes like baseball players, tennis players, swimmers, and golfers are more prone to it in the arm, shoulder, or elbow. A sudden heavy strain can also trigger tendinitis.
Usually, biceps tendinitis occurs with other shoulder problems, such as:
- Dislocated shoulder
- Shoulder arthritis
- Shoulder impingement syndrome
Symptoms of Biceps Tendinitis
- Pain or inflammation in the front of the shoulder, worsening with overhead movements.
- Discomfort when reaching backwards, like fastening a seatbelt or putting on a coat.
- Aching or pain that spreads down the upper arm.
- Occasional snapping sounds or feelings in the shoulder.
Causes of Biceps Tendinitis
Biceps tendonitis develops from daily wear and tear on the tendons. As you age, these tendons weaken, and overuse can worsen the condition. Repeated shoulder movements increase the risk. This is especially the case for those who frequently perform overhead motions, such as baseball players, golfers, tennis players, and swimmers.
Risk Factors
Several factors can increase the likelihood of biceps tendinitis:
- Ageing
- Repeated overhead movements
- Arthritis
- Engaging in sports or physical activity
- Smoking
Diagnosis and Tests
Your GP will review your medical history and ask about your symptoms before conducting a physical exam. Next, they will assess biceps function and examine your shoulder for strength, range of motion and signs of instability.
Imaging tests:
To confirm the diagnosis, your doctor may use:
- X-rays – While they only show bones, they can reveal other shoulder joint issues.
- MRI (magnetic resonance imaging) and ultrasound – These provide a detailed view of soft tissues, including the biceps tendon with better detail unlike X-rays. They help determine the following:
- The level of tendon irritation
- The amount of inflammation
- Whether or not the tendon is torn
Treatment Options
Nonsurgical treatment
Most cases of biceps tendinitis improve with nonsurgical care, which includes:
- Rest – Avoiding movements that trigger pain is the initial step to recovery.
- Ice therapy – Applying cold packs for at least 20 minutes several times each day helps reduce swelling. Avoid direct contact with the skin.
- NSAIDs (nonsteroidal anti-inflammatory drugs) – Medications such as aspirin, ibuprofen, and naproxen help relieve pain and inflammation.
- Steroid injections – Cortisone injections can effectively reduce inflammation and pain. These are often guided by imaging, such as ultrasound in order to ensure accuracy.
- Physical therapy – Targeted stretching and strengthening workouts improve range of motion and shoulder strength.
Surgical treatment
If nonsurgical methods fail or symptoms return, surgery may be an option, especially if other shoulder issues are present.
Most biceps tendinitis surgeries are done arthroscopically. A small camera (arthroscope) is inserted into the shoulder, allowing the surgeon to assess the biceps tendon and surrounding structures while using tiny instruments for the procedure.
Types of surgical procedures include:
- Repair – In rare cases, the biceps tendon is reattached to the (glenoid) shoulder socket. This is usually a suitable treatment option for young, highly active individuals.
- Biceps tenodesis – The damaged part of the tendon is taken out, and the remaining section is reattached to the upper arm bone (humerus). This helps relieve pain and restore function. The procedure can be done arthroscopically or via a small open cut.
- Tenotomy – If the tendon is too damaged to repair, it may be released from the bone. This is the least invasive option but can cause a “Popeye bulge” in the arm. However, most patients recover well after a short period and regain near-normal strength.
Rehabilitation after surgery
Rehabilitation is usually recommended after surgery depending on the type of procedure done. One may need to use a sling for a few weeks. Also, activity restrictions help protect the healing tendon. It’s advisable to adhere to the provider’s instructions to prevent repaired biceps damage.
Therapeutic exercises usually begin a few weeks post-surgery, sometimes with physical therapy. Flexibility exercises help restore shoulder movement. In addition, strengthening exercises are gradually introduced to regain shoulder stability.
Conclusion
Biceps tendonitis is a common condition that can often be managed with rest, therapy, and other non-invasive treatments. However, if symptoms persist or worsen, surgical options may help restore function and relieve pain.
Early intervention can prevent further damage and help you regain full mobility. You should thus schedule an appointment with us if you experience persistent shoulder pain or discomfort. We will help you determine the best treatment plan.