Biceps Tendinitis (long head)

Introduction:

The long head of the biceps plays a crucial role in shoulder function, running along the bicipital groove and attaching to the superior labrum. Biceps tendinitis (long head) is a common condition characterized by inflammation or irritation of the biceps tendon, which connects the biceps muscle to the shoulder joint. This condition can cause significant discomfort and limit the range of motion in the affected arm. Understanding the causes, symptoms, and treatment options for biceps tendinitis is crucial for effectively managing this condition and restoring arm function.

What is Biceps Tendinitis?

Biceps tendinitis occurs when the biceps tendon becomes inflamed or irritated due to repetitive overuse, injury, or age-related degeneration. This inflammation can lead to pain, swelling, and stiffness in the front of the shoulder. 

Causes of Biceps Tendinitis:

1. Overuse: Activities that involve repetitive overhead motions, such as throwing sports or weightlifting, can strain the biceps tendon and lead to inflammation.
2. Shoulder Impingement: Impingement of the biceps tendon between the shoulder bones (acromion and humerus) can cause irritation and inflammation.
3. Age-related Changes: As we age, the tendons in our body may become less flexible and more prone to injury, increasing the risk of biceps tendinitis.
4. Shoulder Instability: Conditions such as shoulder dislocation or instability can place excessive stress on the biceps tendon, leading to inflammation and pain.

Common symptoms of biceps tendinitis include:

1. Pain or tenderness in the front of the shoulder, especially with overhead movements or lifting objects.
2. Swelling or redness around the affected area.
3. Stiffness or weakness in the shoulder.
4. Difficulty performing activities that require overhead arm movements, such as reaching or lifting.

Treatment Options for Biceps Tendinitis:

Treatment for biceps tendinitis aims to reduce pain, inflammation, and improve the function of the affected arm. Common treatment options include:

1. Rest: Avoiding activities that aggravate the symptoms can help alleviate pain and allow the tendon to heal.
2. Ice Therapy: Applying ice packs to the affected area can help reduce swelling and inflammation.
3. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help relieve pain and reduce inflammation.
4. Physical Therapy: A structured physical therapy program can help strengthen the muscles around the shoulder and elbow joints, improving stability and reducing the risk of future injury.
5. Corticosteroid Injections: In severe cases, corticosteroid injections may be recommended to reduce inflammation and alleviate pain.
6. Surgery: In rare cases where conservative treatments fail to provide relief, surgical intervention may be necessary to repair the damaged biceps tendon or address underlying shoulder problems.

Biceps Surgery (long head)- Tenodesis vs Tenotomy

​Biceps tenotomy and tenodesis are surgical procedures aimed at addressing issues with the biceps tendon. Each procedure offers unique benefits and considerations, depending on the patient's age, activity level, and the extent of tendon involvement.

Biceps Tenotomy:

Biceps tenotomy involves the surgical release of the biceps tendon from its attachment to the superior labrum. This procedure effectively relieves tension on the tendon and alleviates associated pain. By detaching the tendon from the labrum, biceps tenotomy eliminates the source of discomfort without the need for reattachment.

Biceps Tenodesis:

In contrast, biceps tenodesis involves the reattachment of the biceps tendon after its release from the superior labrum. However, instead of reattaching the tendon at its original site, it is secured lower down on the humerus (arm bone). This technique aims to maintain the functional integrity of the biceps muscle while addressing underlying pathology.

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