Biceps Tendon Injuries

Biceps tendonitis is inflammation of the long head of the tendon.  Biceps tendonitis can lead to pain and weakness at the front of the shoulder, often making simple tasks such as lifting, reaching, or brushing hair challenging. Typically, biceps tendonitis is marked by irritation or damage to the tendon where it attaches to the top of the shoulder socket, a region known as the glenoid. In some cases, the inflammation may spread down the tendon toward the elbow. The condition generally develops gradually due to repetitive overuse, resulting in persistent pain, weakness, and discomfort in the shoulder. If the inflammation is not treated, it can lead to a partial or complete tear of the tendon.

The symptoms of biceps tendonitis can vary, but they generally include:

• Pain and tenderness at the front of the shoulder, which may radiate down the upper arm.
• Pain when bending the arm or raising it overhead.
• Tenderness in the upper arm where the tendon passes over the arm bone.
• A feeling of weakness in the shoulder, especially when lifting or reaching overhead.
• A clicking or popping sensation in the shoulder when moving the arm.
• Pain that worsens with activities involving repetitive or overhead motions, such as throwing, lifting, or swimming.
• Difficulty or discomfort when rotating the arm or extending it outward.

Symptoms can range from mild discomfort to sharp, intense pain, depending on the severity of the inflammation or damage to the tendon. If left untreated, biceps tendonitis can worsen and lead to more significant shoulder issues, including rotator cuff injuries or tendon tears.

Biceps tendonitis is often caused by repetitive shoulder movements that place excessive strain on the tendon. Typically, the biceps tendon can become damaged over the course of life. This results in degeneration which can be worsened by repetitive shoulder movements.

Common causes include:

• Overuse: Frequent, repetitive overhead motions, such as those seen in sports like baseball, tennis, or swimming, can lead to overuse injuries. Occupations requiring repetitive lifting or reaching can also contribute to biceps tendonitis.
• Shoulder Impingement: Conditions like shoulder impingement can cause the biceps tendon to rub against the bones or tissues in the shoulder, leading to inflammation.
• Aging: Over time, the biceps tendon can naturally weaken and become more prone to injuries, making older adults more susceptible to biceps tendonitis.
• Trauma: Sudden injuries, such as falls, catching something from falling or direct impacts to the shoulder, can damage the biceps tendon, resulting in acute inflammation.

Diagnosing biceps tendonitis begins with a thorough examination by an experienced orthopedic specialist like Dr. Ziegler. During the initial evaluation, Dr. Ziegler will review the patient’s medical history, including any previous shoulder injuries, and ask about the specific symptoms being experienced. A physical examination will be conducted to assess the range of motion, strength, and areas of tenderness in the shoulder.

In addition to the clinical evaluation, diagnostic imaging may be used to confirm the diagnosis and determine the extent of the injury. Techniques such as X-rays and MRI scans can help identify inflammation, tears, or other structural abnormalities within the tendon. Ultrasound imaging is also a useful tool to provide a detailed view of the biceps tendon and surrounding tissues, helping Dr. Ziegler develop a comprehensive treatment plan.