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Biciptal Tendonitis: Bicep Tendonitis in Shoulder

 When an inflammation occurs in the tendons of the long head of the biceps muscle, the term bicipital tendonitis is used for that or we can also say as biceps tendonitis. The foremost function of the biceps muscle is forearm supination and elbow flexion. The biceps add up to 10 percent of the whole power in shoulder abduction during external rotation of the arm. 


Bicipital tendonitis weakens the potential of a person to perform daily activities. It also occurs as secondary to shoulder disorder .i.e. rotator cuff injuries, labral tears, and intra-articular pathology. The cases of primary bicipital tendonitis are very much less as compared to secondary cases. oftentimes, it can be relieved with rest and proper medication. But if the patient does not get better with that, then surgery is another option. 

What are the causes of bicipital tendinitis?

Tendon deterioration: The overhead motion of athletics and the normal aging process degenerate the tendon and cause bicipital tendonitis. 

What are the risk factors for bicipital tendonitis?

Aging:

With aging, wear and tear occur and that weakens our tendons. 

Repeated motions: 

Repetition of the same motion again and again in the presence of degenerated tendon will lead to bicipital tendonitis.

Playing sports: 

Those sports which need repetitive overhead motion .i.e. swimming, baseball, and tennis have a high risk because of overuse damage in the tendon. 

What are the symptoms of bicipital tendonitis?

  1. The patient will suffer from pain in front of the shoulder.
  2. The pain aggravates or worsens when the patient does any overhead lifting or activity. 
  3. The pain might radiate down the upper arm bone. 
  4. The occurrence of sensation or snap sound in the shoulder. 

How to diagnose bicipital tendonitis?

As a doctor, we can diagnose the presence of bicipital tendonitis through a physical exam. In that exam, we will check the strength, range of motion, and shoulder instability signs. Also, some tests help in better diagnosing and these are the imaging tests .i.e. X-ray, and MRI. 

Bicipital Tendonitis Treatment:

There are two options for bicipital tendonitis treatment. One is non-surgical, and the other is surgical methods. The first line of treatment is always non-surgical and most effective. If the non-surgical treatment does not work and does not make any betterment, then we will go for the surgical treatment. 

Non-Surgical Treatment:

The non-surgical treatment includes resting, icing, medications, steroid injection, and physical therapy.

Resting:

Resting is the prime step on the way to recovery. Make sure to avoid those activities which cause pain while resting.

Icing: 

Put in the ice or cold pack for just 20 minutes because it will reduce the swelling. Make sure to not apply directly to the skin.

Medication:

NSAIDs are beneficial in reducing pain as well as swelling. Some of these NSAIDs are ibuprofen, asprin, and neproxen.   

Steroid Injections:

Steroid injections help reduce pain. The doctor will inject these injections into the tendon with caution because it can also weaken the already injured tendon and cause it to tear. 

Physical Therapy: 

Physical therapy helps in bringing back the original range of motion and also strengthening the shoulder. 

Surgical Treatment of Bicep Tendonitis:

Surgical treatment is better done with arthroscopy. An arthroscope is a small camera that surgeons install inside the shoulder joint. So now the inside pictures of the shoulder joint are being displayed on the television screen and these images help the surgeon to use the miniature surgical tools. Some of the surgical treatments are:
  1. Repair
  2. Tenotomy
  3. Biceps Tenodesis

1. Repair: 

In the repairing process, the surgeon repairs the tendon of the biceps that are attached to the shoulder glenoid. 

2. Tenetomy: Sometimes the biceps tendon is severely damaged that it becomes impossible to repair. So the surgeon opts to cut the damaged portion of the biceps tendon from its attachment. This procedure is simply known as bicep tenotomy. Within 30 minutes, the patient feels changes in his muscles of the arm and that is known as Popeye Bulge.  

 3. Biceps Tenodesis: In bicep tenodesis, the surgeon detaches the tendon from the labrum, and connects it with the upper arm bone .i.e. humerus. This surgical procedure sorts out the symptoms and brings back the normal function. 





 

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