Diagnosis: Biceps Tendinitis
Presentation:
Biceps tendonitis is the inflammation of the biceps tendon due to overuse of the muscle. It presents as a pain in front of the shoulder with movement, it is also very common for other shoulder injuries to be present i.e. labrum tears, rotator cuff muscle problems. Some patients will have some snapping and clicking in the shoulder throughout movement. The activities that cause the most pain are normally overhead activities and things like throwing, which really stress the shoulder joint and the biceps tendon.
Causes:
Tendinitis is a condition that is caused by overuse of a tendon. Tendonitis caused by overuse is commonly seen when the patient rapidly increases their activity, rather than gradually i.e. if an athlete were to go from playing a sport once a week to playing four times a week, they increase their risk of getting overuse tendonitis and other overuse injuries. Biceps tendonitis can be caused by weight training, particularly bench press and “dips”. This overuse injury can also occur when activity is not increased, but another shoulder injury is present. Any other shoulder injury i.e. a labrum tear can change the mechanics of the shoulder and cause the biceps muscle to work harder during normal activity and this also has the potential to cause biceps tendinitis (Micheli, 2010).
Tendinitis is a condition that is caused by overuse of a tendon. #performbetter @pogophysio Click To TweetDiagnosis:
Biceps tendonitis can be diagnosed by a physiotherapist and radiography is also commonly used. A physiotherapist will perform specific special tests to produce pain over the biceps tendon. The therapist will also perform many shoulder tests to rule out other shoulder problems, although other shoulder problems are likely to be present. Radiography may also be used to diagnose tendinitis, ultrasound can be used to observe inflammation and fiber disorganisation in a biceps tendon which suggests a diagnosis of biceps tendonitis (Chen, Lin, Hsu, Chen, & Kang, 2011).
Treatment:
Recovery from tendonitis can be a long process. The first stage of treatment is eliminating the cause of the injury. In an overuse case where the patient has rapidly increased their activity, relative rest is advised. It is very important to not completely rest from that activity but to decrease the amount that the patient is doing. As a general rule activity should be halved. It is ok to perform the activity with mild pain, however when the pain becomes severe it is best to stop. It is very important that activity is not completely ceased as this will cause disarray in the fibers of the biceps tendon and the injury will almost immediately return when activity is commenced again. In cases where the tendonitis is caused by another shoulder injury the process is to treat that shoulder injury first and return the mechanics to normal.
Physiotherapy treatment and exercises are very important in tendinitis recovery, a therapist will prescribe exercises focusing on shoulder and elbow strength and stability, exercises that specifically target the biceps tendon are also used. During exercises that target the damaged tendon it is important to focus on slow, controlled lowering of the weight or lengthening of the muscle. Regular icing, massage and shoulder taping are also effective in relieving pain and inflammation around the tendon (Brukner & Khan, 2012).
Daniel O’Connor
Student Physiotherapist
References
Brukner, P. & Khan, K. (2012). Brukner & Khan’s clinical sports medicine (pp. 373-374). Sydney: McGraw-Hill
Chen, H., Lin, S., Hsu, Y., Chen, S., & Kang, J. (2011). A Comparison of Physical Examinations with Musculoskeletal Ultrasound in the Diagnosis of Biceps Long Head Tendinitis. Ultrasound In Medicine & Biology, 37(9), 1392-1398.
Micheli, L. (2010). Encyclopedia of Sports Medicine (p. 72). Thousand Oaks: SAGE Publications.
