What Is Biceps Tendonitis?

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Shot of a sporty young man suffering from a sports injury outdoors

Many people book a visit to the doctor thinking that they have some kind of tear in their shoulder, when in fact they have biceps tendonitis.

How can you tell the difference? Biceps tendonitis is the inflammation of the ‘tendon’ that connects your biceps muscle in the upper arm to the shoulder. This cord-like structure helps your arm to rotate and bend. Biceps tendonitis is usually caused by wear and tear of the shoulder or overuse from repeating the same shoulder motions.

Symptoms may include weakness and pain in the front of the shoulder, especially with rotational use of the arm, such as taking off a shirt or putting on a seatbelt. The area may be tender to the touch and the pain might be intermittent. Discomfort may become worse when you bend your arm or use it to reach over your head. You may also hear or feel a snap.

How Is Biceps Tendonitis Treated?

The first line of treatment is always to rest the shoulder and avoid activities that cause pain. “The best ways to prevent tendon problems are to warm up properly, stretch and cool down,” says Jacob G. Calcei, MD, an orthopedic sports medicine physician and shoulder surgeon at University Hospitals.

“Listen to your body when soreness doesn’t go away in a few days. Cross-training is very helpful for maintaining good overall strength and flexibility can alleviate symptoms,” says Dr. Calcei.

You can also ice the area and try over the counter medications like ibuprofen and naproxen to ease the pain and inflammation. Patients with this condition typically benefit from an ultrasound-guided cortisone injection which can be very effective in reducing both inflammation and pain. You may also be directed to try specific physical therapy exercises to stretch, strengthen and restore mobility to the area.

If these non-surgical options do not provide relief, and the pain significantly interferes with your daily life, you may need to consider surgical treatment.

Can Tendonitis Turn into a Biceps Tear?

In most cases, tendonitis will resolve within six months to a year. But if overuse continues to be a problem, it is possible to develop a biceps tear. There are degrees of biceps tears and many people live with minor tearing without problem.

A partial or full tear of the biceps tendon is also caused by injury or overuse. The tendon is usually prone to injury as it runs through the shoulder joint and connects to the rim of the socket.

Small tears can happen as the shoulder is used in the same way over and over through the years. As the shoulder tendons weaken over time and with aging, they become more prone to tearing.

While magnetic resonance imaging (MRI) may be helpful to rule out other more serious shoulder problems, an MRI will not show all tears. Ultimately, this means that a surgeon may need to use arthroscopy, a small tube that is inserted into the body and attached to a small video camera, to best determine the severity of the tear or treat the patient based on their physical symptoms.

As for treatment options, a new technology known as percutaneous tenotomy is a very minimally invasive alternative. “This new technology, which can help to remove scar tissue from around an irritated tendon, has been shown to be very effective with virtually no side effects, quick recovery, and a high success rate,” says Dr. Calcei.

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At University Hospitals, our fellowship-trained sports medicine specialists, primary care doctors, nutritionists, sleep experts and other health care professionals ensure the very best in health and medical care for athletes. As the official health care partner for the Cleveland Browns, our team of experts provide care on and off the field, from peewee to pro. Learn more about sports medicine services at University Hospitals.

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