Pain in the anterior of the shoulder and instability are common symptoms of biceps tendinitis. They can frequently be relieved with rest and medication. In severe cases, surgery can be required to repair the tendon.
Your shoulder is a ball and socket joint made up of three bones, your upper arm bone, humerus, shoulder blade (collarbone (clavicle) and scapula.
Glenoid . The head of your arm bone fits into the rounded socket in your shoulder blade. This socket is called the glenoid. The glenoid is lined with soft cartilage referred to as the labrum. This tissue assists the head of the upper arm fit into the shoulder socket.
Rotator cuff. A combination of muscles and tendons holds your arm joined within your shoulder socket. These tissues are described as the rotator cuffs. They covered the head of your upper arm bone and connected to your shoulder blade.
Biceps tendons, The biceps muscle in is the front of your upper arm. It has two ligaments that attach it to bones in the shoulder. The long head connects to the top of the shoulder socket glenoid
The short head of the biceps tendon connects the bones in the shoulder blade called the coracoid process. The coracoid is a triangular anterior process of the mandibular ramus, providing the link to the temporal muscle. This is a bracket like projection from the anterior portion of the proximal extremity of the ulna, giving attachment to the brachial muscle and opening into the formation of the trochlear notch.
Biceps tendinitis is caused swelling of the long head of the biceps tendon. In its first stages, the tendon becomes red and swollen. As tendonitis occurs, the tendon sheath (covering) can thicken. The tendon itself often enlarges or grows thicker.
The tendon is these late stages is often dark red in color caused by inflammation. Occasionally, the damage to the tendon can result in a tendon can result in a tendon tear, and then deformation of the arm (a “Popeye” bulge in the upper arm).
- Biceps tendinitis usually occurs along with other shoulder problems. In many 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 produce swelling of the shoulder joint lining.
Cause of Bicep Tendonitis
In most cases, damage to the biceps tendon is caused by a lifetime of normal activities. As we age, our tendons slowly debilitate with everyday wear and tear. This degeneration can be worsened by overuse reading the same shoulder movements over and over.
Many jobs and routine chores can trigger overuse damage. Sports activities 0 particularly those that require repetitive overhead motion, such as swimming baseball, tennis, can also put people at risk fo biceps tendinitis
The repetitive overhead motion may play a part in other shoulder problems that occur with biceps tendinitis. Rotator cuff tears. Osteoarthritis and Chronic shoulder weakness are often caused by becoming worn out.
Pain or tenderness in the front of the shoulder, which worsens with overhead with overhead lifting or activity.
Pain or achiness that goes down the upper arm bone
An occasional snapping sound or sensation in the shoulder
After reviewing your symptoms and medical records, your doctor will examine your shoulder.
During the examination, your physician will assess your shoulder from a range of motion and signs of shoulder instability. Also, he or she will perform specific physical examination test to check the function of your biceps.
Another test that may help your doctor confirm your diagnosis include:
X-rays Although they only visualize bones, x-rays may show other issues in your shoulder joint.
Magnetic resonance imaging (MRI) and ultrasound. These pictures can show soft tissues like the biceps tendon in greater detail.
Your orthopedic surgeon will carefully to identify any other problems in your
shoulder and treat them along with your tendinitis,
Biceps tendinitis is generally first treated with simple methods,
Rest- The first step toward recovery is to avoid activities that cause pain.
Ice – Apply cold packs for 20 minutes at a time, several times a day, to keep swelling down. Do not administer ice directly to the skin,
Nonsteroidal anti-inflammatory medicines. Medications like ibuprofen and naproxen reduce pain and swelling.
Steroid injection such as cortisone is very effective anti-inflammatory medicines. Injecting steroid into the tendon can relieve pain. You doctor will use these cautiously. IN rare circumstances, steroid doses can further weaken already injured tendon c causing it to tear.
Physical therapy Specific stretching and muscle building workouts can help restore array of motion and strengthen your shoulder.
If your health does not restore with nonsurgical treatment, your doctor may offer surgery. Surgery may also be an option if you have other shoulder problems.
Surgery for biceps tendinitis is usually accomplished arthroscopically. This enables your doctor to evaluate the condition of the biceps tendon as well as other formations in the shoulder.
During arthroscopy, your surgeon inputs a small camera called an arthroscope, into your shoulder joint. The camera displays pictures on a televised screen, and your surgeon uses these images to guide small surgical instruments.
Repair . Rarely, the biceps tendon can be improved where it attaches to the shoulder socket (glenoid).
Biceps tendonitis. In some cases, the damaged region of the biceps is removed, and the remaining tendon is reattached to the upper arm bone (humerus). This operation is called a biceps stenosis. Removing the painful part of the biceps normally resolves symptoms and restores normal function.
Depending on your situation your surgeon may choose to do this procedure arthroscopically or by an open incision.
Tenotomy. In critical cases, the long head of the biceps tendon may be so impaired that it is not feasible to repair or tenodese it. Your surgeon may simply choose to release the damaged biceps tendon from its attachment. This is described a biceps tenotomy. This alternative is the least invasive but may produce a Popeye bulge in the arm.
Surgical complications. Overall, complication rates are low, and your surgeon can correct them without difficulty.
Bleeding, stiffness, infection, and other problems are possible complications. These are more prone to occur in open surgical procedures than in arthroscopic surgeries.
Rehabilitation. After surgery, your doctor will designate a rehabilitation program based on the procedures implemented. You may wear a sling for a few weeks to protect the tendon repair.
You should have quick use of your hand for daily task— writing, eating, washing, using the computer, or washing. Your doctor may reduce certain activities to allow the repaired tendon to heal. It is important to comprehend your doctor’s directions after surgery to avoid harm to your repaired biceps.
Your doctor will soon commence your therapeutic exercises. Flexibility exercises will increase the range of motion in your shoulder. Exercises to strengthen your shoulder will continuously be added to your rehabilitation plan.
Surgical outcome. Most patients have good outcomes. They typically recover full range of motion and can move their arms without pain. People who play very high-demand overhead sports occasionally need to limit these activities after surgery.’