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Biceps Tendonitis

What is Biceps Tendonitis?

We typically see biceps tendonitis in individuals that are very active. This can include athletics, but also work related activities. Depending on whether the shoulder side of the muscle or the forearm side of the muscle is involved, people may experience pain in different locations. 

What causes Biceps Tendonitis?

How is Biceps Tendonitis treated?

The biceps is a muscle in the upper. It is mainly involved in elbow flexion and forearm supination (turning the palm up). The "Bi" in Biceps implies that there are "two" parts to the muscle. Where a muscle enters bone, it becomes a tendon. Therefore, there are two tendons that make up the biceps muscle around the shoulder. At the elbow, the muscle combines into a single tendon that inserts into the forearm. When the biceps tendon becomes inflamed at either the shoulder side of the muscle or at the forearm side of the muscle, the condition is known as biceps tendonitis. This condition is similar to tendonosis which is a chronic degradation of the tendon tissue.

Most cases of biceps tendonitis or biceps tendonosis are related to overuse activities. Therefore, we try activity modficiation to change or limit the activities that are causing the pain. Similarly, some patients benefit from physical therapy to rehabilitation the muscle. In certain situations patients may benefit from an ultrasound guided steroid injection in the shoulder area to treat their inflammation. If these injections are successful at reducing your pain, you may be a candidate for a biceps tenodesis. This is an arthroscopic procedure that treats the area around the biceps tendon in your shoulder and re-attaches the tendon in a new location on your upper arm to remove the diseased tendon and decrease pain, while preserving the function of the muscle. We typically use an absorbable anchor with sutures to reattach the tendon on the upper arm bone.

Two Biceps Tendons

One Biceps Tendon

Animated image of the biceps muscle anatomy and position on the human skeleton. Images courtesy of WikiCommons.

The biceps muscle of the arm. Image courtesy of WikiCommons.

This MRI is an axial or transverse image through the shoulder. The Biceps tendon is highlighted by the arrow. The white area around the tendon indicates a tear and inflammation. Image courtesy of Dr. Skelley.

References

1. Papp DF, Skelley NW, Sutter EG, Ji JH, Wierks CH, Belkoff SM, McFarland EG. Biomechanical Evaluation of Open Suture Anchor Fixation Versus Interference Screw for Biceps Tenodesis. Orthopedics. 2011;34(7):e275-278. doi:10.3928/01477447-20110526-04.

2. Papp, D., Skelley, N., Wierks, C., Jong Hun, J., Belkoff, S., McFarland, E. Biomechanical Evaluation of Modified Suture Anchor Fixation for Biceps Tenodesis Versus Interference Screw. Poster presented at: American Academy of Orthopaedic Surgeons 2010 Meeting; New Orleans, LA. March 2010.

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