Bicipital Tendonitis

Bicipital tendonitis refers to redness, soreness, and swelling (inflammation) or irritation of the bicep tendon. The biceps muscle is located between the elbow and shoulder of the inner arm. The tendon heads, similar to pieces of rope, connect the bicep muscle to the shoulder socket. They are called short head and long head tendons. When tendonitis occurs, the long head tendon is inflamed and swollen, and may be thickened or partially torn.

Bicipital tendonitis can occur with other problems as well, such as arthritis in the shoulder or acromioclavicular joints, tears in the tendons, or other rotator cuff problems.

CAUSES

Overuse of of the arms for overhead activities is the major cause of tendonitis. Many athletes, such as swimmers, baseball players, and tennis players are prone to bicipital tendonitis. Jobs that require manual labor or routine chores, especially chores involving overhead activities can result in overuse and tendonitis.

SYMPTOMS

Symptoms may include:

  • Pain in and around the front of the shoulder. Pain may be worse with overhead motion.

  • Pain or aching that radiates down the arm.

  • Clicking or shifting sensations in the shoulder.

DIAGNOSIS

Your caregiver may perform the following:

  • Physical exam and tests of the biceps and shoulder to observe range of motion, strength, and stability.

  • X-rays or magnetic resonance imaging (MRI) to confirm the diagnosis. In most common cases, these tests are not necessary.

Since other problems may exist in the shoulder or rotator cuff, additional tests may be recommended.

TREATMENT

Treatment may include the following:

  • Medications

  • Your caregiver may prescribe over-the-counter pain relievers.

  • Steroid injections, such as cortisone, may be recommended. These may help to reduce inflammation and pain.

  • Physical Therapy - Your caregiver may recommend gentle exercises with the arm. These can help restore strength and range of motion. They may be done at home or with a physical therapist's supervision and input.

  • Surgery - Arthroscopic or open surgery sometimes is necessary. Surgery may include:

  • Reattachment or repair of the tendon at the shoulder socket.

  • Removal of the damaged section of the tendon.

  • Anchoring the tendon to a different area of the shoulder (tenodesis).

HOME CARE INSTRUCTIONS

  • Avoid overhead motion of the affected arm or any other motion that causes pain.

  • Take medication for pain as directed. Do not take these for more than 3 weeks, unless directed to do so by your caregiver.

  • Ice the affected area for 20 minutes at a time, 3-4 times per day. Place a towel on the skin over the painful area and the ice or cold pack over the towel. Do not place ice directly on the skin.

  • Perform gentle exercises at home as directed. These will increase strength and flexibility.

PREVENTION

  • Modify your activities as much as possible to protect your arm. A physical therapist or sports medicine physician can help you understand options for safe motion.

  • Avoid repetitive overhead pulling, lifting, reaching, and throwing until your caregiver tells you it is ok to resume these activities.

SEEK MEDICAL CARE IF:

  • Your pain worsens.

  • You have difficulty moving the affected arm.

  • You have trouble performing any of the self-care instructions.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.