Your shoulder consists of three bones in a ball-and-socket configuration: the upper arm bone, shoulder blade, and collarbone. The bicep muscle is attached to the shoulder bone by tendons and one end of the upper arm bone sits in the shoulder socket. Cartilage helps secure the upper arm bone into the socket.
The rotator cuff is made up of muscles and tendons that keep the arm centered in the socket. They surround the end of the upper arm bone that goes into the socket. The biceps muscle is located at the front of the upper arm and is attached to the shoulder bones with two tendons. The long bicep head is attached to the shoulder socket, while the short head attaches to a different part of the shoulder blade called the coracoid process.
Most cases of biceps tendinitis are caused by normal activities carried out over a lifetime. As with the rest of the body, tendons have a tendency to weaken with age. Overuse can speed up this degeneration, such as what might occur as a result of performing repetitive activities or chores.
Jobs requiring manual labor can contribute to this condition, as well as sports that require repeated overhead motions, such as baseball, tennis, and swimming. Note that these types of motions can also contribute to some of the other problems associated with biceps tendinitis. For example, overuse has also been linked to osteoarthritis and rotator cuff tears.
Common symptoms of biceps tendinitis include the following:
– Pain along the front of the shoulder area, where it meets the bicep. The pain gets worse when lifting objects overhead, or occasionally when bending and extending the arm at the elbow.
– Aching or pain along the upper arm bone.
– Snapping sensations in the shoulder.
Note that in many cases, these symptoms go away with rest and ice application.
If biceps tendinitis is suspected, a doctor or will make their diagnosis based on your personal history, symptoms, and a clinical examination. The doctor will check the shoulder’s strength and range of motions, as well as looking for signs of instability. They will check your bicep for signs of swelling and tenderness, as well as assessing its functionality.
Your doctor may determine that additional tests are needed. While x-rays are only able to visualize bones, they can sometimes show indications of other problems affecting the shoulder joint. However, the best known methods for confirming the diagnosis are through MRI and Ultrasonography, as they show greater detail.
Before prescribing treatment, your doctor will first identify any other shoulder-related conditions, in order to treat them alongside the tendinitis. In most cases, nonsurgical treatment is typically preferred. The first step is to avoid any activities that might agitate the condition. Cold packs are then used to reduce swelling.
To help reduce both swelling and pain, nonsteroidal anti-inflammatory medications, such as naproxen and ibuprofen, will likely be recommended first. If additional medication is needed, cortisone injections may be employed. Doctors tend to use these cautiously, since cortisone is a steroid and repeated injections may further weaken the injured tendon.
Your doctor is also likely to prescribe special exercises, at some point. These are intended to both stretch and strengthen the affected area. Avoid doing any other activities that may aggravate the condition while undergoing physical therapy.
Surgery is a last resort and is unlikely, unless the condition doesn’t improve or involves other shoulder problems. Most surgeries for tendinitis are performed arthroscopically, allowing the doctor to utilize a small camera to guide the surgical instruments. Some cases may require removing damaged sections of the tendon and reattaching it to the bone. In other cases, the tendon may be so damaged that it must be completely detached. This may result in a permanent bulge at the location.
If you think you may have bicep tendinitis, you should see a doctor before it gets worse. The sooner you get diagnosed, the sooner you can begin treatment and get back to your normal routine. Waiting too long increases the chances that you’ll exacerbate the injury, resulting in lengthier treatment.
Plano Orthopedic Sports Medicine and Spine Center is a full-service medical facility specializing in the evaluation and treatment of orthopedic injuries. Our practice is led by a group of 12 board-certified and fellowship-trained orthopedic surgeons and a physical medicine and rehabilitation physicians. With locations in Plano and Frisco, the physicians at Plano Orthopedic have been recognized as the Best Doctors in Dallas and Collin County D Magazine. They have also been honored as Super Doctors in Texas Monthly, including several who are Texas Hall of Fame SuperDoctors by their peers since 2003. Contact us today!