Biceps Tendinitis

A tendon is part of the muscle that attaches muscle to bone. It is a strong, fibrous tissue that is responsible for transferring the forces generated by the muscle to the bone, thus producing movement at the joint. When a tendon becomes irritated or inflamed it can be painful, especially with movement. Inflammation of the tendon is called tendinitis.

Tendinitis of the shoulder typically occurs in the subacromial space and is common due to the anatomy of the shoulder coupled with stressful activity assigned to the joint. The subacromial space is an area on the top the shoulder formed by the coracoacromial arch. This arch is formed by the acromioclavicular joint, coracoacromial ligament and acromion (outer edge of the shoulder blade).

The chief tendons of the shoulder, the rotator cuff and long head of the biceps, pass under this arch. Reduction of this space exposes the tendons to a high risk for friction, rubbing and irritation, setting the stage for a case of tendinitis. Tendon problems usually emerge in individuals 40 to 60 years old but are increasingly being seen in young athletes as a byproduct of repetitive overuse.

Biceps tendinitis is the inflammation of the upper biceps tendon. Several muscles and tendons keep the arm anchored in the shoulder joint and the head of the humerus (upper arm bone) fits into the joint socket. One of these muscles is the long head of the biceps tendon that attaches to the glenoid labrum.

This tendon is responsible for bending the elbow (flexion), turning the forearm (supination) and raising the arm overhead. It is commonly irritated with repetitive overhead activities and routine lifting that may result in pain and weakness in the shoulder. Increased age can increase the potential for a rupture.

Biceps Tendinitis is most diagnosed as an overuse repetitive strain injury (RSI). Other high risk activities or conditions that can lead to the development of biceps tendinitis include:

• Participating in activities requiring overhead motions like swimming, tennis, softball and baseball.
• Repetitive strain injuries (RSI) at work are common in people performing activities habitually in nature such as assembly line work.
• Sudden injury to the region like a fall on the shoulder.
• Patients suffering from rheumatoid arthritis may have an increased risk to tendinitis.
• Aging resulting in changes to tendon elasticity and circulation that increase susceptibility to injury and reduce ability to heal.
• Postural factors like a forward head and shoulder posture reducing the subacromial space, thus leading to irritation of the shoulder tendons.
• Overload injuries derived from lifting heavy objects or weight training.
• Weakening of the rotator cuff causing a muscular imbalance resulting in shoulder impingement (pinching).

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