Overview:
Biceps tendinitis is a condition characterised by inflammation or irritation of the biceps tendon, a thick cord-like structure that connects the biceps muscle to the shoulder joint. This tendon plays a crucial role in arm movement and stability, particularly during activities involving overhead motion.
Anatomy:
The biceps tendon runs from the biceps muscle in the upper arm, passing through the shoulder joint and attaching to the top of the shoulder socket (glenoid). Its function is to facilitate various movements of the arm, including flexion (bending) and supination (rotation palm-upward).
Causes:
Biceps tendinitis often develops due to repetitive overhead arm movements, such as those seen in sports like baseball, tennis, or swimming. Other contributing factors may include:
- Overuse: Continuous strain on the biceps tendon from repetitive activities or improper lifting techniques can lead to inflammation and subsequent tendinitis.
- Shoulder instability: Conditions like shoulder impingement syndrome or rotator cuff tears can alter the mechanics of the shoulder joint, increasing stress on the biceps tendon and predisposing it to injury.
- Age-related changes: Degenerative changes in the tendon structure, commonly seen in older adults, can weaken the tendon and make it more susceptible to inflammation and injury.
Symptoms:
Common symptoms of biceps tendinitis include:
- Pain in the front of the shoulder, which may radiate down the upper arm.
- Tenderness and swelling in the affected area.
- Difficulty with overhead activities or lifting objects.
- Weakness in the affected arm, particularly when attempting to flex or rotate the forearm.
- Crepitus or crackling sensation with arm movement.
Diagnosis:
Diagnosing biceps tendinitis typically involves a comprehensive evaluation by a healthcare professional, including:
- Medical history: Discussion of symptoms, onset, and aggravating factors.
- Physical examination: Assessment of shoulder range of motion, strength, and tenderness.
- Imaging studies: X-rays, ultrasound, or MRI scans may be ordered to visualise the biceps tendon and assess for any structural abnormalities or signs of inflammation.
Treatment:
Treatment options for biceps tendinitis aim to reduce pain, inflammation, and improve shoulder function. Common approaches include:
- Rest and activity modification: Avoiding activities that exacerbate symptoms and allowing adequate time for the tendon to heal.
- Ice therapy: Applying ice packs to the affected area for 15-20 minutes several times a day to reduce swelling and pain.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen may help alleviate pain and inflammation.
- Physical therapy: Performing specific exercises to strengthen the shoulder muscles, improve flexibility, and correct biomechanical imbalances.
- Corticosteroid injections: Injections of corticosteroids into the biceps tendon sheath can provide temporary relief of pain and inflammation.
- Surgical intervention: In cases of severe or persistent symptoms, surgical procedures such as biceps tenotomy (tendon release) or tenodesis (tendon reattachment) may be considered to alleviate symptoms and restore function.
Prevention:
Preventing biceps tendinitis involves:
- Gradually increasing the intensity and duration of physical activities to avoid overloading the shoulder.
- Practising proper lifting techniques and using ergonomic equipment to reduce strain on the shoulder joint.
- Incorporating regular stretching and strengthening exercises for the shoulder muscles to maintain flexibility and stability.
Outlook:
With appropriate treatment and rehabilitation, most individuals with biceps tendinitis experience significant improvement in symptoms and return to their normal activities. However, adherence to preventive measures and ongoing shoulder conditioning is essential to minimise the risk of recurrence. If symptoms persist or worsen, it is important to seek further evaluation and treatment from a healthcare professional.
