The Biceps is the muscle on the front of your arm – its the one that bulges when you bend your elbow.
It is attached via tendons to the shoulder blade (scapula) and your radius (one of the two bones in your forearm)
Near its attachment to the scapula, the biceps tendon runs through the shoulder joint and along the top of your humerus (arm bone). As you get older, it can degenerate (wear and tear) and can become inflammed. An inflammed tendon is called tendonitis.
Biceps tendonitis can lead to a complete rupture of your biceps tendon. This would lead to a ‘pop eye’ deformity – where your biceps muscle bunches up near your elbow.
Symptoms of Biceps Tendonitis
- Pain. Usually located around the top of your humerus (arm bone)
- Worse with certain movements. When turn your hand from palm facing down to palm facing up.
Cause of Biceps Tendonitis
- Age. Biceps tendonitis is more common if you are age 40 years and above.
- Associated with rotator cuff tears. Biceps tendonitis is commonly seen with rotator cuff problems such as shoulder impingement and rotator cuff tears.
Investigation
- Ultrasound.
- MRI.
Treatment of Biceps Tendonitis
Treat of biceps tendonitis depends on the severity of your pain.
Mild Pain
If your pain is mild, your pain can be treated with rest, anti-inflammatory medications, physiotherapy and modification of your activities.
Severe Pain
If your pain isn’t releaved by the above measures, then surgery may be necessary.
There are 2 operations that are commonly performed for biceps tendonitis:
- Biceps tenotomy. This operation can be performed using key hole surgery (arthroscopy). A camera and instruments are passed through 1cm incisions to cut the biceps tendon. This releases your biceps tendon, and relieves your pain, but leads to a bunching of your biceps muscle that can lead to a change in the shape of your arm.
- Biceps tenodesis. In this operation, the cut end of the biceps is reattached to the top end of the arm bone (humerus). It can be done via a 4 cm incision or via key hole surgery.
Further reading and References
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Pain and the pathogenesis of biceps tendinopathy. Am J Transl Res. 2017 Jun 15;9(6):2668-2683.
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Long head of biceps: from anatomy to treatment. Acta Reumatol Port. 2015 Jan-Mar;40(1):26-33. Review.
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The long head of biceps and associated tendinopathy. J Bone Joint Surg Br. 2007 Aug;89(8):1001-9. Review.