Bicipital Tendonitis
Bicipital Tendonitis is an inflammation of the tendons that connect the Bicipital
muscles to the bones in the shoulder. The Bicipital 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 Bicipital Tendonitis
Local tenderness usually is present over the Bicipital 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 Bicipital 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 Bicipital 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.
Bicipital Tendonitis with labral tears or rotator cuff tears may not improve if all the
diagnoses are not treated.
Causes of Bicipital Tendonitis
The long head tendon passes down the Bicipital 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
Bicipital 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 Bicipital tendon due to excessive motion of the humeral head.
Labral tears may disrupt the Bicipital anchor, resulting in dysfunction causing pain.
Other diagnostic considerations: The transverse humeral ligament holds the Bicipital
tendon long head within the Bicipital groove. Injuries and disruption of the ligament can
lead to subluxation and medial dislocation of the tendon
Treatment of Biceps 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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