Tendonitis of the Bicep

One type of tendonitis of the arm is bicep tendonitis. The bicep muscle, in the front of the upper arm, helps stabilize the upper arm bone (humerus) in the shoulder socket. It also helps accelerate and decelerate the arm during overhead movement in activities like tennis or pitching. Strong, cord-like structures called tendons connect one end of the biceps muscle to the shoulder in two places. At the other end of the muscle, tendons connect the biceps muscle to the smaller bone (radius) in the lower arm. If the tendons become inflamed or irritated, the condition is called tendonitis.

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Symptoms

  • Pain when the arm is overhead or bent.
  • Localized tenderness as the tendon passes over the groove in the upper arm bone.
  • Snapping sound or sensation in the shoulder area.

Causes and Risk Factors

Injuries to the biceps tendons are commonly caused by repetitive overhead activity.

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Diagnosis

During the physical examination, the doctor will review the shoulder area for range of motion, tenderness and signs of shoulder instability. X-ray may be taken to uncover related conditions that might cause irritation, and an MRI might be taken to rule out damage to the tendons. Overuse, aging and stress can cause the tendon to deteriorate, even if there is no inflammation present.

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Treatments

The first step is to rest the arm and shoulder, and avoid overuse and activities that irritate the arm. Icing and nonsteroidal anti-inflammatory drugs such as ibuprofen can help reduce tenderness and swelling (inflammation). Your doctor can also recommend stretching and strengthening exercises to build muscle endurance and restore range of motion. Then you can slowly return to activities that involve raising your arm over your head.

If the pain is caused by the shoulder joint not being stable or by pressure on the tendon from the shoulder bones, your doctor may recommend arthroscopic surgery. Using fiber optic technology and miniature instruments inserted through a small incision, the surgeon can examine the shoulder joint and anchor the tendon properly.

After surgery, your doctor will prescribe a physical therapy program that includes stretching and strengthening. Early movement is important, but you should wait for your doctor's approval before doing any heavy lifting or returning to sports.

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