Biceps Tendinitis

What is the biceps tendon?

The biceps tendon is a strong, fibrous structure that connects the biceps muscle to the bones in the shoulder (scapula). The biceps tendon near the shoulder is comprised of 2 structures: (1) The long head of the biceps which originates from the shoulder’s labrum, and (2) the short head that originates from the coracoid process of the scapula (shoulder blade). The biceps muscle and tendons facilitate shoulder and elbow flexion.

What causes biceps tendinitis?

Biceps tendonitis is a condition characterized by inflammation and irritation of the tendon. It can often develop due to repetitive overhead activities. Biceps tendonitis may occur in isolation or in conjunction with other problems of the shoulder, such as rotator cuff tears, impingement, and more. Several factors contribute to its development:

• Repetitive Movements: Engaging in activities that require repetitive overhead arm movements, such as lifting heavy objects, throwing, swimming, tennis, or certain work-related tasks, can strain the biceps tendon. Over time, this strain can lead to irritation and inflammation, causing tendinitis.
• Age and Degeneration: As people age, tendons may undergo natural wear and tear, becoming less flexible and more prone to injury. Degeneration of the tendon with age can predispose individuals to biceps tendinitis.
• Poor Biomechanics: Incorrect lifting techniques or performing tasks with improper form can place excessive stress on the biceps tendon leading to tendinitis.
• Shoulder Impingement: Biceps tendinitis can also occur as a result of shoulder impingement, where the structures in the shoulder, including the biceps tendon, get pinched or compressed between the bones during certain arm movements. This can lead to inflammation and irritation of the tendon.
• Trauma or Injury: Sudden injuries or trauma to the shoulder or arm, such as a fall or direct impact, can damage the biceps tendon, leading to tendinitis.
• Muscle Imbalances: Weakness or imbalances in the muscles around the shoulder joint can affect the mechanics of the arm, potentially placing more strain on the biceps tendon and contributing to tendinitis.
• Medical Conditions: Some medical conditions, like arthritis or autoimmune diseases, can predispose individuals to tendon inflammation, including biceps tendinitis.

What are the symptoms of biceps tendinitis?

Biceps tendinitis typically manifests through several distinct symptoms. Pain in the front of the shoulder is a hallmark sign, often described as a dull ache or throbbing sensation. This discomfort tends to worsen with specific movements, such as reaching overhead or lifting objects. Tenderness and swelling in the affected area, specifically along the front of the shoulder or the upper arm, are common. Individuals might notice a clicking or snapping sensation in the shoulder. Limited range of motion in the shoulder joint, especially when trying to lift the arm or rotate it, is another prevalent symptom. In some cases, individuals may experience weakness in the affected arm, making tasks that involve lifting or carrying objects more challenging.

How is biceps tendinitis diagnosed?

Dr. Shane J Nho performs a comprehensive evaluation in diagnosing biceps tendinitis that includes first learning the individual’s present symptoms, medical history, and activities that worsen their shoulder pain. He then conducts a thorough physical examination focused on assessing the range of motion in the shoulder joint and identifying which specific shoulder movements recreate their shoulder pain. To confirm the diagnosis, imaging tests such as magnetic resonance imaging (MRI) scans may be ordered to visualize the biceps tendon and surrounding structures, identifying signs of inflammation or tendon damage. In some cases, diagnostic injections may be utilized where a numbing medication is injected into the area around the biceps tendon to help identify if the pain is stemming from that region.