Biceps Tendonitis is an inflammation of the longhead of the biceps, the muscle is in the front of your upper arm. The biceps helps you bend your elbow and rotate your arm. It also helps keep your shoulder stable, which is why biceps tendonitis is considered a shoulder condition.
It can develop on its own or after an injury and can be found with other shoulder joint problems.
It can also be caused by the rubbing of bony prominences in the bicipital groove.
This can be a very painful condition. The pain is usually present in the front of the shoulder. In slim people the tendon can be felt at the front of the shoulder joint and this can cause pain.
Treatment of biceps tendonitis is usually conservative – rest, anti-inflammatories and physiotherapy. Injections – a mix of local anaesthetic and steroids – are also effective. The most accurate and effective way to administer these injections is by using ultrasound guidance.
If conservative treatment fails, surgery is an option. There are two types of surgeries that can be done.
Tenotomy involves cutting the tendon. Usually this is done in older patients where the so-called Popeye lesion will not be visible. A patient may lose a bit of power in the arm that’s been operated on, but this is not a functional impairment.
A patient may also experience cramps in the biceps muscle, but this usually passes after six to eight weeks.
In biceps tenodesis, the second type of operation, the tendon is cut and then fixed to the bone. This is done during keyhole surgery and is often done with a rotator cuff repair.
Advantages of tenodesis are that cosmetically it helps prevent the ‘Popeye’ lesion and in young, active people, the loss of strength that accompanies a tenotomy is eliminated.
Some patients do still have a Popeye lesion or cramping, but much less than with a tenotomy.
Studies that looked at the outcomes of the two operations could not find any difference between the two on the outcome measures used.