A painful condition that affects shoulder and arm movement and often causes sleep disturbance, biceps tendonitis arises when there is inflammation to the long-head bicep tendon. Common in sports and professions that involve repetitive overhead activity, this overuse injury is rarely seen in isolation. In other words, it typically exists alongside other pathologies such as rotator cuff injuries, shoulder instability, labral (shoulder fibrocartilage) tears and arthritis. Read on to discover all you need to know about biceps tendonitis, its causes, and its treatment.
Understanding the biceps muscle
Situated in the front of the upper arm between the shoulder and elbow, the biceps muscle is made up of a short head and a long head. The short head attaches to the top anterior portion of the shoulder. The long head passes through a groove at the front of the shoulder, through the shoulder joint and attaches at the top of the shoulder, making it more susceptible to inflammation and injury.
Biceps tendonitis is often present in conjunction with injuries to the rotator cuff (muscles on the back and top of the shoulder that provide stability to the shoulder joint) and/or shoulder instability because the pain, weakness and poor biomechanics in the overall shoulder function places excessive load on the biceps.
What are the symptoms of biceps tendonitis?
Those with biceps tendonitis will experience pain in the front of the shoulder, especially when lifting or performing overhead movements such as pulling on a jumper or putting on a jacket. There will be pain and/or weakness with shoulder flexion, ie. when lifting the arm forward and above the head. Other symptoms may include pain radiating to the elbow, pain and/or weakness when bending the elbow, pain on reaching into the back seat of the car and a clicking noise accompanying shoulder movement in the affected arm. Patients with biceps tendonitis typically also complain of pain when sleeping on the affected shoulder.
Why does biceps tendonitis occur?
Biceps tendonitis is most often brought about by repetitive overhead actions. For instance, it is regularly seen in athletes involved in sports that require overhead activities, such as baseball (pitching), tennis (serving), and swimming. Those in jobs that require overhead activity and lifting (eg. painters, builders) are also at risk. In some instances, biceps tendonitis is brought about by trauma, while tendinosis – chronic, non-inflamed tendon discomfort due to degeneration – can be a problem for the older population.
How is it biceps tendonitis diagnosed, treated & prevented from recurring?
Your physio will first take a thorough history of your injury, assess the range, strength and function of the neck, shoulder and thoracic spine to rule out other potential pathologies. Further investigation may be required in the form of an ultrasound or MRI.
If there is inflammation to the tendon (tendonitis), the first stages of treatment will typically include anti-inflammatories, ice and rest. Patients with acute biceps tendonitis – as well as the chronic, non-inflamed condition, tendinosis – will need to embark on a strengthening program.
To rehabilitate the area and prevent biceps tendonitis from recurring, it is important to strengthen the shoulder muscles and scapula, and improve posture and neck and thoracic (upper back) flexibility. Your physiotherapist will provide you with suitable exercises, and educate you on how to improve your lifting/overhead technique.
If you feel like you may be suffering from biceps tendonitis, call Collins Place Physio today on 9650 2220 to get your rehabilitation under way.