Biceps tendinitis

Biceps tendinitis

Shoulder Condition

Biceps Tendinitis​

Biceps tendinitis is an inflammation or irritation of the upper biceps tendon. Also called the long head of the biceps tendon, this strong, cord-like structure connects the biceps muscle to the bones in the shoulder.

The biceps muscle is in the front of your upper arm. It has two tendons that attach it to bones in the shoulder. The long head attaches to the top of the shoulder socket (glenoid).

The short head of the biceps tendon attaches to a bump on the shoulder blade called the coracoid process.

Biceps tendinitis is inflammation of the long head of the biceps tendon. In its early stages, the tendon becomes red and swollen. As tendinitis develops, the tendon sheath (covering) can thicken. The tendon itself often thickens or grows larger.

Occasionally, the damage to the tendon can result in a tendon tear, and then deformity of the arm (a “Popeye” bulge in the upper arm).

Description

Biceps tendinitis usually occurs along with other shoulder problems. In most cases, there is also damage to the rotator cuff tendon. Other problems that often accompany biceps tendinitis include:

  • Arthritis of the shoulder joint
  • Tears in the glenoid labrum
  • Chronic shoulder instability (dislocation)
  • Shoulder impingement
  • Other diseases that cause inflammation of the shoulder joint lining

 
Many jobs and routine chores can cause overuse damage. Sports activities — particularly those that require repetitive overhead motion, such as swimming, tennis, and baseball — can also put people at risk for biceps tendinitis.

Treatment
  • Non-surgical treatment
  • Biceps tendinitis is typically first treated with simple methods.
  • Rest.
  • Ice.
  • Nonsteroidal anti-inflammatory medicines.
  • Steroid injections.
  • Physical therapy.
Surgical treatment

If your condition does not improve with nonsurgical treatment, your doctor may offer surgery. Surgery may also be an option if you have other shoulder problems.

Biceps tenodesis. In some cases, the damaged section of the biceps is removed, and the remaining tendon is reattached to the humerus. This procedure is called a biceps tenodesis. Removing the painful part of the biceps usually resolves symptoms and restores normal function. Depending on your situation, your surgeon may choose to do this procedure arthroscopically or through an open incision.

Tenotomy. In severe cases, the long head of the biceps tendon may be so damaged that it is not possible to repair or tenodese it. Your surgeon may simply elect to release the damaged biceps tendon from its attachment. This is called a biceps tenotomy. This option is the least invasive, but may result in a Popeye bulge in the arm.

Rehabilitation

After surgery, your doctor will prescribe a rehabilitation plan based on the procedures performed. You may wear a sling for a few weeks to protect the tendon repair.

You should have immediate use of your hand for daily activities — writing, using a computer, eating, or washing. Your doctor may restrict certain activities to allow the repaired tendon to heal.

Flexibility exercises will improve range of motion in your shoulder. Exercises to strengthen your shoulder will gradually be added to your rehabilitation plan.