Tendonitis

The long head tendon of the bicep, the large muscle of the upper arm, can develop tendonitis (inflammation of the tendon) from primary inflammation or in conjunction with other injuries pertaining to the shoulder. The bicep tendon originates from the tissue in the glenohumeral joint (shoulder socket). Chronic inflammation causes the tendon to thicken and leads to the formation of scar tissue. Tendonitis in the bicep causes pain in the front of the shoulder and radiates down the bicep. The tendonitis is usually related to overuse with no history of trauma. Anti-inflammatory drugs and range-of-motion exercises can treat the pain and regain strength. Corticosteroid injections also help with treating the sheath of the tendon.  Occasionally when these non-surgical treatments fail, surgery can be performed to alleviate biceps tendon pain.

Subluxation

Subluxation, a partial dislocation, of the bicep occurs when the bicep tendon comes out of a groove on the humerus (upper arm bone) – (similar to a rope running through a groove in a pulley). Subluxation of the bicep causes pain radiating down the arm and a “popping” feeling in the shoulder/arm when they move. Conservative therapy is recommended, and surgical intervention is sometimes encouraged as a primary treatment plan for younger athletes.

Rupture

The long head tendon of the bicep, the large muscle of the upper arm, can rupture or tear from acute trauma. The most common cause is a forceful flexion of the elbow against heavy resistance. Rupturing of the bicep tendon will cause tenderness, bruising, and swelling of the bicep muscle in the mid-upper arm (the “Popeye” deformity). Certain SLAP tears of the labrum in the shoulder socket can lead to the detachment of the bicep tendon as well. Surgery is recommended to reattach the tendon in athletes and restore the strength of the upper arm. In older patients, therapy, pain control, and maintaining mobility are the biggest priorities before surgery is considered.