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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.
 Tendonitis (also spelled tendinitis) is an inflammation of a tendon. Generally tendonitis is referred to by the body part involved, such as Achillies tendonitis (inflammation of the Achilles tendon), or patellar tendonitis (jumper's knee; inflammation of the patellar tendon). Chronic overuse of tendons leads to microscopic tears within the collagen matrix, which gradually weakens the tissue. Tendonitis can also be associated with systemic inflammatory diseases such as rheumatoid arthritis.
 
 
 
 
 
   

This web site is intended for your own informational purposes only. No person or entity associated with this web site purports to be engaging in the practice of medicine through this medium. The information you receive is not intended as a substitute for the advice of a physician or other health care professional. If you have an illness or medical problem, contact your health care provider.

05/27/2011

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