What is proximal biceps tendinitis?
Found along the anterior humerus (upper arm bone) are two muscles known as the biceps. These muscles originate at two separate sites on the shoulder but join together in the middle of the upper arm to form one large muscle belly that is attached to the radial tuberosity on the elbow. The proximal biceps are secured to the humerus by two tendons. The long head of the biceps tendon passes through the shoulder joint and is directly attached to the superior labrum. The short head of the biceps tendon is attached to the coracoid process of the scapula (shoulder blade). When these tendons become irritated, most commonly the long head of the biceps tendon, it results in proximal biceps tendinitis.
Athletes that perform repetitive shoulder movements, seen in baseball, swimming, cricket, tennis, Lacrosse, and volleyball, are at a greater risk for developing proximal biceps tendinitis. Although these repetitive motions are frequently the source of tendon inflammation, other shoulder conditions, such as osteoarthritis, a rotator cuff injury, bone spurs, or shoulder trauma, can also precipitate inflammation of these tendons. Dr. Ronak Mukesh Patel, orthopedic shoulder specialist serving patients in Sugar Land, Pearland, and the Houston, Texas area, has the knowledge and understanding, as well as substantial experience in treating patients who have experienced proximal biceps tendinitis.
What are the symptoms of proximal biceps tendinitis?
A common complaint of proximal biceps tendinitis is pain and tenderness along the anterior portion of the shoulder. Other common symptoms of proximal biceps tendinitis include:
- Shoulder pain with upper arm movement
- Pain that radiates down the upper arm
- A snapping or slipping sensation with shoulder movement
How is proximal biceps tendinitis diagnosed?
Dr. Patel will gather a detailed medical history to include the initial injury and then perform a thorough physical examination to support a proximal biceps tendinitis diagnosis. Dr. Patel may also request diagnostic testing, such as x-rays and magnetic resonance imaging (MRI), to rule out any damage to the other structures within the shoulder joint. Additional diagnostic imaging utilizing injected dye, known as an arthrogram, may also be warranted to identify any damage to the shoulder joint.
What is the treatment for proximal biceps tendinitis?
Non-surgical treatment:
The recommended treatment for patients with a confirmed diagnosis of proximal biceps tendinitis is non-surgical therapy. The pain and inflammation associated with this condition can be managed with a combination of rest, ice, and non-steroidal anti-inflammatory medications (NSAIDs). If the pain still persists with oral medications, a corticosteroid injection can be administered directly into the long head of the biceps tendon. When appropriate, Dr. Patel will prescribe a physical therapy program aimed at strengthening the biceps tendons and improving shoulder range of motion.
Surgical treatment:
If a patient continues to experience substantial pain or inflammation, or in the event of failed non-surgical therapy, a shoulder arthroscopy may be recommended by Dr. Patel. This minimally invasive surgical procedure utilizes a small camera (arthroscope) to examine the muscles and tendons of the shoulder. By methodically examining these shoulder structures with the arthroscope, Dr. Patel can determine the best option for repairing the tendons with the following techniques:
- Biceps tenotomy: The biceps tendon is released from its attachment site in this surgical technique. This procedure is generally reserved for when the biceps tendon cannot be repaired through other surgical techniques.
- Biceps tenodesis: In this procedure, the damaged fragments of the biceps tendon are excised and removed using specialized surgical instruments. The remaining tissue is then fastened to the humerus with special surgical anchors. This surgical technique is used when a tendon tear results from the inflammation.
Biceps Injury Specialist
Have you experienced radiating pain and tenderness in the shoulder, especially with movement of the upper arm? If so, you may be experiencing proximal biceps tendinitis. This condition is diagnosed with a physical examination and diagnostic imagine. Shoulder specialist, Doctor Ronak Mukesh Patel, provides nonsurgical and surgical treatment options for patients in Houston, Sugar Land, and Pearland, TX experiencing shoulder pain. Contact Dr. Patel’s team today!
