Biceps Tendinitis

What is biceps tendinitis?

The biceps muscle travels along the front of upper arm (humerus) and splits into two portions near the shoulder. The two portions of the biceps muscle are the short head and the long head. The long head of the biceps tendon is directly attached to the superior labrum and passes through the shoulder joint. The short head of the biceps tendon is attached to the coracoid process of the scapula (shoulder blade). Biceps tendinitis is inflammation of one or both of these tendons, but is more common to the long head of the biceps tendon. Repetitive shoulder use, such as those associated with athletic activities, is typically the cause for inflammation. Other shoulder conditions, impingement syndrome, osteoarthritis, rotator cuff tears, or shoulder trauma, can cause inflammation of these tendons as well. Dr. Riley J. Williams, orthopedic shoulder specialist serving patients in Manhattan, Brooklyn, New York City, NY and surrounding areas, has the knowledge and understanding, as well as substantial experience in treating patients who have experienced biceps tendinitis.

What are the symptoms of biceps tendinitis?

The most common complaint of biceps tendinitis is pain and tenderness at the upper arm and anterior shoulder. Other symptoms include:

• Pain that radiates down the upper arm
• Pain with movement of the upper arm or flexing of the forearm
• A snapping or slipping sensation with shoulder movement
• Dull ache in the front of the shoulder
• Inability to hold the arm in certain positions

How is biceps tendinitis diagnosed?

Dr. Williams can diagnose biceps tendinitis with a comprehensive medical history and physical examination. Diagnostic testing, including x-rays and magnetic resonance imaging (MRI), may be utilized to identify damage to other structures within the shoulder. Rarely, an arthrogram may also be ordered in circumstances where an MRI is not possible.

What is the treatment for biceps tendinitis?

Non-surgical treatment:

Conservative therapy is the recommended course of action for patients who have been diagnosed with biceps tendinitis. Ice, non-steroidal anti-inflammatory medications, and activity modification can reduce the pain and inflammation associated with this condition. If the shoulder pain is still prevalent or not relieved by oral medications, a corticosteroid injection directly adjacent to the long head of the biceps tendon can provide substantial relief. Once the pain and inflammation have diminished, Dr. Williams will recommend a physical rehabilitation program aimed at strengthening the tendons and restoring range of motion to the shoulder.

Surgical treatment:

If a patient is experiencing persistent inflammation or pain and conservative therapy is unsuccessful, a shoulder arthroscopy is recommended. This minimally invasive surgical procedure uses a small camera (arthroscope) to view the bones, tendons and muscles of the shoulder joint. Dr. Williams will typically indicate affected patients for one of the following repair options:

• Biceps tenodesis: This surgical treatment involves the removal of the damaged portion of the tendon; the remaining tendon is then reattached to the humerus using specialized fixation devices.
• Bicep tenotomy: This approach is utilized when the biceps tendon cannot be repaired through other surgical methods. In this procedure, Dr. Williams releases the biceps tendon from its attachment site.

For more information on biceps tendinitis, or the excellent treatment options available for your shoulder condition, please contact the office of Dr. Riley J. Williams, an orthopedic shoulder specialist serving Manhattan, Brooklyn, New York City, NY and surrounding areas.