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What Is Biceps Tendonitis ?

Biceps tendonitis, also called bicipital tendonitis, is one of the more common causes of shoulder pain. Tendonitis, also called tendinitis, is a general term, which means inflammation of a tendon. A tendon is a body tissue that connects your muscle to your bone. In biceps tendonitis, the long head of the biceps in the shoulder area becomes inflamed causing pain.



Often, biceps tendonitis occurs in people whose work or activity involves repetitive, overhead movements. The condition can develop over time wherein pain is felt at the front part of the shoulder, which can worsen with continued activity.

Biceps tendonitis often occurs with other shoulder conditions, the most common of which is rotator cuff injury. Other shoulder problems that may occur along with biceps tendonitis include:
  • Arthritis in the shoulder joint
  • Shoulder impingement
  • Chronic shoulder instability
  • Labral tear

What is the long head of the biceps muscle?

Your biceps muscle is located in front of your upper arm. It is attached to your shoulder bone via two tendons – the long head and the short head. The long head of your biceps muscle attaches to the top of your shoulder socket. The biceps short head attaches your biceps to a bony bump in front of your shoulder blade called the coracoids process.

Causes

Occurrence of biceps tendonitis is often associated with long-term (chronic) repetitive overhead activities. Our tendons slowly weaken as we age because of everyday wear and tear. This slow degeneration of tendon tissues can be worsened by shoulder overuse.

In the early stages of biceps tendonitis, your biceps tendon becomes red or swollen. As the condition progresses, the biceps tendon’s covering – called tendon sheath – thickens. Occasionally, further damage to the tendon may result in tendon tear

People whose work involves lifting objects especially pulling and pushing overhead are at risk for developing biceps tendonitis. Participating in certain sports that require repetitive overhead movements may put you at risk for developing this condition. Examples of such sports include:
  • Weightlifting
  • Swimming
  • Baseball
  • Cricket
  • Rowing, and
  • Kayaking

Symptoms

The most common symptom of biceps tendonitis is pain in the front of the shoulder. This is often made worse with overhead lifting or activity. Other symptoms you may experience include:
  • Tenderness at the front of your shoulder
  • Swelling
  • Feeling of shoulder giving way when lifting or reaching overhead
  • Sensation of “snapping” or “clicking” in the front of your shoulder when you do shoulder motion
  • Difficulty moving your affected shoulder to perform daily tasks, such as wearing your shirt or putting away dishes in an overhead cabinet

How is this condition diagnosed?

During your visit to your doctor, you will be asked about your symptoms and your medical history. After which, he or she will perform a thorough physical examination of your shoulder. Your doctor may have to move your arm or ask you to perform certain movements during your shoulder examination. Your doctor will also perform certain physical examination tests to help with correct diagnosis.

Imaging tests are not usually necessary to diagnose biceps tendonitis. However, if your doctor suspects other shoulder problems that you might have, he or she may request diagnostic imaging of your shoulder. This will help rule out any other shoulder condition.

Treatments

Your doctor will first consider the nonsurgical approach for treating your biceps tendonitis.

Rest. This is very important. Avoid activities or shoulder movements that worsen your pain, especially overhead activities.

Ice application. Apply cold packs for about 15 to 20 minutes at a time, several times a day, to keep swelling down. Do not apply ice directly to the skin. Your doctor or physical therapist can help teach you on how to properly apply ice on your injury.

Nonsteroidal anti-inflammatory drugs. Your doctor may prescribe you pain medication, such as ibuprofen or naproxen to help reduce your pain and swelling.

Physical therapy. Your physical therapist will create a comprehensive treatment plan based on your specific problems. He or she can help you perform proper stretching and strengthening exercises that will help you restore your shoulder range of motion and strength. In addition, your therapist can provide you with techniques to help you prevent further or future shoulder injury.

Surgery may not be necessary if your condition improves with conservative treatments. However, your doctor may recommend surgery if your condition does not improve, worsens, or when you have other shoulder problems present.

After you surgery, you doctor may refer you to physical therapy for rehabilitation to help you get back to your normal activities.

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