Arm Tendonitis
Arm Tendonitis is an inflammation of the tendons that connect the biceps muscles to the
bones in the shoulder. The biceps muscle splits into two tendons at the shoulder. A long
one and a short one. The long tendon runs over the top of the humerus bone (upper arm) and
attaches to the top of the shoulder blade. Inflammation of this tendon is a fairly common
complaint especially with swimmers, rowers, throwers, golfers and weight lifters.
Diagnosis of Arm Tendonitis
Local tenderness usually is present over the Biceps groove, which typically is located
3 inches below the anterior acromion and may be localized best with the arm in 10° of
external rotation.
Flexion of the elbow against resistance aggravates pain.
Passive abduction of the arm in a painful arc maneuver typical of impingement syndrome
may elicit pain; however, this finding may be negative in isolated biceps Tendonitis.
Speed test: Patient complains of anterior shoulder pain with flexion of the shoulder
against resistance, while the elbow is extended and the forearm is supinated.
Yergason test: The patient complains of pain and tenderness over the Biceps groove with
forearm supination against resistance with the elbow flexed and the shoulder in adduction.
Popping of subluxation of the tendon may be demonstrated with this maneuver.
The remainder of the examination should be to document active and passive range of
motion (ROM) and joint stability in order to assess the rotator cuff and glenoid labrum. A
complete evaluation includes a complete neurovascular assessment as well.
Biceps Tendonitis with labral tears or rotator cuff tears may not improve if all the
diagnoses are not treated.
Causes of Arm Tendonitis
The long head tendon passes down the Biceps groove in a fibrous sheath between the
subscapularis and supraspinatus tendons. This relationship causes the tendon to undergo
degenerative and attritional changes associated with rotator cuff disease because it
shares the associated inflammatory process within the suprahumeral joint.
Full humeral head abduction places the attachment area of the rotator cuff and biceps
tendon under the acromion. External rotation of the humerus at or above the horizontal
level compresses these suprahumeral structures into the anterior acromion. Repeated
irritation leads to inflammation, edema, microscopic tearing, and degenerative changes.
In younger athletes, relative instability due to hyperlaxity may cause similar
inflammatory changes on the Biceps tendon due to excessive motion of the humeral head.
Labral tears may disrupt the biceps anchor, resulting in dysfunction causing pain.
Other diagnostic considerations: The transverse humeral ligament holds the biceps
tendon long head within the Biceps groove. Injuries and disruption of the ligament can
lead to subluxation and medial dislocation of the tendon
Treatment of Arm Tendonitis
- placing ice packs on your shoulder for 20 to 30 minutes every 3 to 4 hours for 2 or 3
days or until the pain goes away
- taking anti-inflammatory medication
- getting an injection of a corticosteroid medication to reduce the inflammation and pain
- doing rehabilitation exercises.
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