Biceps Tendonitis

Biceps Tendonitis: Understanding the Condition and its Causes

What is Biceps Tendonitis?

Biceps tendonitis is a condition that involves inflammation or irritation of the biceps tendon, which connects the biceps muscle to the shoulder and elbow joints. 

It typically occurs as a result of overuse or repetitive strain on the tendon, and is often seen in athletes or individuals who perform activities that require repetitive overhead motions or heavy lifting. 

Over time, this inflammation can lead to pain, weakness, and reduced range of motion in the shoulder and elbow joints.

Biceps Tendonitis: Anatomy

 

To understand biceps tendonitis, it’s important to have a basic understanding of the anatomy of the biceps muscle and tendon. 

The biceps muscle is located on the front of the upper arm and is responsible for flexing the elbow joint and rotating the forearm.

The muscle has two heads, the long head and the short head, which are attached to the scapula (shoulder blade) and merge (come together) to form a single tendon that attaches to the radius bone in the forearm. 

The long head of the biceps tendon passes through the bicipital groove of the humerus bone in the shoulder joint before attaching to the top of the glenoid labrum (a ring of cartilage that surrounds the shoulder joint). 

The short head attaches to the coracoid process of the Scapula.

Symptoms of Biceps Tendonitis

The symptoms of biceps tendonitis can vary from person to person, but common ones include: 

1. 1. Pain in the front of the shoulder or elbow 

1. 1. Weakness in the affected arm 

1. 1. Tenderness or soreness in the biceps muscle or tendon 

1. 1. Stiffness or limited range of motion in the shoulder or elbow 

1. 1. Pain or discomfort when lifting objects or reaching overhead 

Causes of Biceps Tendonitis

Biceps tendonitis can be caused by a variety of factors, including: 

1. 1. Overuse: Overuse or repetitive strain on the biceps tendon can cause small tears or damage to the tendon, leading to inflammation and pain. 

1. 1. Aging: As we age, our tendons become less elastic and more prone to injury. This can increase the risk of developing biceps tendonitis or a condition called bicipital Tendinopathy (Tendinopathy refers to degeneration within the tendon)

1. 1. Shoulder impingement: Shoulder impingement occurs when the rotator cuff muscles and tendons rub against the bursa and bone in the shoulder. This can cause inflammation and damage to the biceps tendon.

1. 1.  Shoulder instability: Shoulder instability can cause the biceps tendon to become stretched or damaged, leading to biceps tendonitis. 

1. 1. Trauma: A sudden injury or trauma to the shoulder or biceps muscle can cause damage to the biceps tendon and lead to tendonitis or even a tear in the tendon attachment itself

1. 1. Medical conditions: Certain medical conditions, such as rheumatoid arthritis or diabetes, can increase the risk of developing biceps tendonitis. In Diabetes we often see frozen shoulder which presents with Biceps Tenosynovitis which at times is mistaken for Bicipital Tendonitis.

It’s important to identify the underlying cause of biceps tendonitis in order to effectively treat the condition and prevent a future recurrence of injury or pain.

Who is at Risk for Biceps Tendonitis?

Biceps tendonitis can affect anyone, but there are certain factors that may increase the risk of developing this condition, including: 

1. 1. Athletes: Athletes who engage in sports that involve repetitive overhead or lifting movements, such as baseball, tennis, or weightlifting, are at a higher risk of developing biceps tendonitis. 

1. 1. People with manual labour jobs: People who perform manual labour jobs that involve heavy lifting, repetitive lifting movements, or overhead reaching are also at an increased risk of developing biceps tendonitis. 

If you are at an increased risk of developing biceps tendonitis, it’s important to take preventative measures, such as maintaining good posture, practicing proper lifting techniques, and warming up properly before physical activity.

Diagnosis of Biceps Tendonitis

To diagnose biceps tendonitis, a clinician will perform a physical examination and take a medical history.

During the physical exam, they may ask you to perform certain movements or exercises to assess your range of motion and evaluate any pain or tenderness in the affected area. 

There are several tests that can be used to diagnose biceps tendonitis and differentiate it from other conditions which cause similar symptoms. These tests may include: 

1. 1. Physical examination: Assessment of range of motion, strength, and stability of the shoulder joint. Palpation to look for signs of inflammation, such as swelling or tenderness in the tendon. 

1. 1. MRI: Magnetic resonance imaging (MRI) can provide detailed images of the bicep tendon and surrounding tissues, which can help identify any damage.

1. 1. Ultrasound: Ultrasound imaging can be used to assess the thickness and integrity of the biceps tendon, as well as the presence of any fluid or inflammation in the joint. 

1. 1. X-ray: used to assess the bones of the shoulder joint and rule out any fractures or other structural abnormalities.

Early diagnosis and treatment can help prevent further damage to the tendon and improve your chances of a full recovery. 

Treating Biceps Tendonitis: Options and Considerations

 

Biceps Tendonitis Rest and Physical Therapy

Rest is an important component of treating biceps tendonitis, as it allows the tendon to heal and reduces the risk of further injury.

Physical therapy can also be an effective treatment option for biceps tendonitis. A physical therapist or clinician can design a program of exercises and stretches to help reduce pain, improve range of motion, and strengthen the affected area.

Common exercises for biceps tendonitis may include: 

1. 1. Shoulder and elbow stretches to improve flexibility and range of motion 

1. 1. Strengthening exercises for the rotator cuff muscles and other muscles that support the shoulder 

1. 1. Eccentric exercises that focus on strengthening the biceps muscle while lengthening the tendon 

1. 1. Cross-friction massage to help break up scar tissue and promote healing 

1. 1. Ultrasound or other modalities to reduce pain and inflammation 

Your physical therapist can also provide guidance on proper form and technique for activities that may have contributed to the development of biceps tendonitis

It is important to follow your healthcare professional’s recommendations for rest and physical therapy in order to effectively treat biceps tendonitis and prevent future injury.

Medications for Biceps Tendonitis

There are several medications that can be used to treat biceps tendonitis, including: 

1. 1. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen or naproxen, can help reduce pain and inflammation associated with biceps tendonitis. 

1. 1. Topical pain relievers: Topical pain relievers, such as creams or gels containing menthol or capsaicin, can provide temporary relief from pain and discomfort. 

1. 1. Cortisone injections: Cortisone injections can be used to reduce inflammation and provide pain relief in the affected area especially where there is Biceps Tendon Sheath Inflammation

It’s important to talk to your healthcare professional before taking any medications for biceps tendonitis, as they can provide guidance on the appropriate dosage and potential side effects. In some cases, medications may be used in conjunction with other treatments, such as rest and physical therapy, to effectively manage biceps tendonitis.

Surgery for Biceps Tendonitis

Surgery for biceps tendonitis is typically only recommended in severe cases where conservative treatments, such as rest and physical therapy, have not been effective. Surgery may also be considered if there is a complete tear of the biceps tendon or if the condition is causing other complications, such as shoulder instability or rotator cuff tears. 

There are several surgical procedures that may be used to treat biceps tendonitis, including: 

1. 1. Biceps tenodesis: This procedure involves detaching the damaged biceps tendon from the shoulder joint and reattaching it to the upper arm bone (humerus). This can help relieve pain and restore function to the shoulder. 

1. 1. Arthroscopy: In some cases, biceps tendonitis can be treated with arthroscopy, a minimally invasive surgical technique that uses small incisions and a camera to view and repair the damaged tissue. 

Recovery time after surgery for biceps tendonitis can vary depending on the specific procedure and individual factors, such as age and overall health.  

Alternative and Complementary Therapies for Biceps Tendonitis

In addition to conventional treatments, there are several alternative and complementary therapies that may be used to manage symptoms of biceps tendonitis, including: 

1. 1. Acupuncture: Acupuncture involves the insertion of fine needles into specific points on the body to stimulate healing and reduce pain. Some people find acupuncture to be helpful in relieving pain associated with biceps tendonitis. 

1. 1. Massage therapy: Massage therapy can help reduce muscle tension, improve circulation, and promote relaxation, which may help relieve pain and improve function in the affected area. 

These therapies may be used in conjunction with other treatments, such as rest and physical therapy, to effectively manage biceps tendonitis.

Biceps Tendonitis Foods to Eat and Avoid for Tendon Health

Eating a healthy diet can help support tendon health and promote healing from biceps tendonitis. Here are some foods to eat and avoid: 

Foods to eat: 

1. 1. Protein: Protein is essential for repairing and building muscles and tendons. Good sources of protein include lean meats, poultry, fish, beans, lentils, nuts, and seeds

1. 1. Omega-3 fatty acids: Omega-3 fatty acids have anti-inflammatory properties and can help reduce inflammation associated with biceps tendonitis. Good sources of omega-3 fatty acids include fatty fish, such as salmon and tuna, walnuts, flaxseeds, and chia seeds. 

1. 1. Vitamin C: Vitamin C is essential for collagen production, which is important for tendon health. Good sources of vitamin C include citrus fruits, berries, kiwi, broccoli, and bell peppers. 

1. 1. Magnesium: Magnesium is important for muscle and tendon function. Good sources of magnesium include leafy greens, nuts, seeds, and whole grains. 

1. 1. Zinc: Zinc is important for tissue repair and immune function. Good sources of zinc include oysters, beef, poultry, beans, nuts, and seeds. 

Prevention of Biceps Tendonitis Recurrence

 

Preventing recurrence of biceps tendonitis involves reducing the risk factors that led to the initial injury. Here are some strategies to help prevent recurrence: 

1. 1. Warm up and stretch: This can help reduce the risk of injury. 

1. 1. Strengthening exercises: This can help improve the strength and flexibility of the muscles and tendons around the shoulder joint, reducing the risk of injury.

1. 1. Proper technique: This is essential for preventing injury.

1. 1. Rest and recovery: Allow for adequate rest and recovery time between activities or exercises to avoid overuse injuries. 

By following these strategies, you can reduce the risk of recurrence of biceps tendonitis and other shoulder injuries.

Strengthening the Biceps Tendon and Related Muscles 

Strengthening exercises for the biceps tendon and related muscles can help improve muscle and tendon strength and flexibility, reducing the risk of injury and improving recovery from biceps tendonitis. Here are some exercises to consider: 

1. 1. Bicep curls: Bicep curls can help strengthen the biceps muscles and improve flexibility in the biceps tendon. To perform bicep curls, stand with your feet shoulder-width apart and hold a dumbbell in each hand. Curl the dumbbells up towards your shoulders, keeping your elbows close to your body. Lower the weights back down to your sides and repeat for several repetitions. 

1. 1. Hammer curls: Hammer curls can help strengthen the biceps and the brachioradialis muscle, which is important for elbow flexion. To perform hammer curls, stand with your feet shoulder-width apart and hold a dumbbell in each hand with your palms facing inwards. Curl the dumbbells up towards your shoulders, keeping your elbows close to your body. Lower the weights back down to your sides and repeat for several repetitions. 

1. 1. Reverse curls: Reverse curls can help strengthen the brachialis muscle, which is located beneath the biceps muscle. To perform reverse curls, stand with your feet shoulder-width apart and hold a dumbbell in each hand with your palms facing down. Curl the dumbbells up towards your shoulders, keeping your elbows close to your body. Lower the weights back down to your sides and repeat for several repetitions. 

1. 1. Shoulder external rotations: Shoulder external rotations can help strengthen the rotator cuff muscles, which are important for stabilizing the shoulder joint. To perform shoulder external rotations, lie on your side with your affected arm bent at a 90-degree angle. Hold a light weight in your hand and slowly rotate your arm upwards, keeping your elbow at your side. Lower the weight back down and repeat for several repetitions. 

1. 1. Scapular stabilization exercises: Scapular stabilization exercises can help improve shoulder blade stability and reduce the risk of injury. To perform scapular stabilization exercises, sit or stand with your back straight and your shoulders relaxed. Squeeze your shoulder blades together and hold for several seconds, then release. Repeat for several repetitions. 

It’s important to work with a physical therapist or other qualified healthcare professional to develop a strengthening program that is safe and effective for you. They can help you determine the appropriate weights, repetitions, and sets for your individual needs and monitor your progress over time.

Biceps tendonitis is a manageable condition, and with the right strategies and support, you can continue to live well and thrive.