Bicipital tendinitis is an inflammation or irritation of the long head of the biceps tendon. It is a common cause of shoulder pain and impingement, often developing in people who perform repetitive, overhead movements.
The Biceps tendon, associated with the Biceps muscle, is made up of 2 parts: the long head and the short head. The long head of the Biceps is most commonly affected. This strong, cord-like structure connects the biceps muscle to the bones in the shoulder. Occasionally, the damage of the tendon can result in tendon rupture, and it will cause deformity of the arm. (a “Popeye” bulge in the upper arm)
Other conditions that accompany Bicipital Tendinitis
Arthritis of the shoulder joint
Tears in the glenoid labrum
Chronic shoulder instability(dislocation)
Shoulder impingement
Causes for Bicipital Tendinitis
When excessive abnormal forces are applied across the tendon including; tension (pulling of the muscle and the tendon), compression (pushing or pinching), or shearing (rubbing).
In the normal aging process, our tendons get slowly weaken with everyday wear and tear. This can be worsened by overuse.
Sports activities that require repetitive overhead motion, such as swimming, tennis, and baseball can also cause bicipital tendinitis.
Rotator cuff tears.
Weakness in the rotator cuff and muscles of the upper back.
Shoulder joint hypermobility (looseness).
The shoulder joint and/or muscle tightness.
Poor body mechanics.
An abrupt increase in an exercise routine.
Other pathology within the shoulder joint.
Symptoms
Sharp pain or tenderness to touch in the front of the shoulder, which worsens with overhead lifting or activity.
Pain or achiness that moves down the upper arm bone.
An occasional snapping sound or sensation in the shoulder.
Weakness felt around the shoulder joint, usually experienced when lifting or carrying objects or reaching overhead.
Difficulty with daily activities, such as reaching behind your back to tuck in your shirt, or putting dishes away in an overhead cabinet.
Pain when resting that may become worse at night.
Diagnostic procedure
When you first go to see your physical therapist, the therapist will review your medical history, ask you to describe your shoulder condition, and perform a comprehensive physical exam of your shoulder and upper trunk.
Imaging techniques, such as an X-ray or MRI, are typically not needed to diagnose biceps tendinitis. but if your physiotherapist suspects that there are more conditions related to this you'll be referred to an orthopaedist.
Treatment methods of Bicipital Tendinitis
Treatments can be non-surgical or surgical.
01. non-surgical treatment
once you are diagnosed with bicepital tendinitis, your physical therapist will develop an individualized plan and goal specific to your condition. Since physiotherapy treatments start from the acute stage it helps to have an early recovery.
medications also help to relieve pain.
02. Surgical treatment
If the condition does not improve with nonsurgical treatment, you may need to go for surgery.
If bicipital tendinitis is untreated it may lead to adhesive capsulitis/ frozen shoulder.
Ways to prevent
Avoid repetitive overhead activities that cause shoulder pain. If you must perform these activities for your job or sport, make sure you avoid overworking your shoulder and set aside time to properly rest it.
Check your posture. The shoulder, neck, and back are all at risk of injury when they are held in a poor posture over a long period of time. Ask your physical therapist to discuss your work environment; describe how you move (or do not move) throughout the day.
Avoid lifting or carrying heavy objects held away from your body. Have a good posture and keep items close to the body and, when possible, use both hands and both arms to carry a heavy object.
Perform rotator-cuff strengthening exercises regularly. Your physical therapist will teach you exercises to strengthen these muscles and any others that are weak.
Consult with a physical therapist if your symptoms are worsening despite rest.
How does Bicipital tendinitis differ from rupture of Biceps tendon?
When a rupture occurs, there can be seen a bulge in the upper arm above the elbow (“Popeye Muscle”), because a torn tendon can no longer keep the muscle tight. But in bicipital tendinitis, you cannot see that.
An audible pop or snap can hear when the rupture occurs but in tendinitis, we cannot hear such sound.
Sachini Gunasekara
References
https://orthoinfo.aaos.org/en/diseases--conditions/biceps-tendinitis/
https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-biceps-tendinitis
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