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Biceps Tendonitis

The biceps muscle in the arm has 2 tendons at its origin and one tendon for insertion.

One of the tendons of origin, the long head of biceps, passes over the top of the arm bone (known as the humeral head) through a groove, into the shoulder joint and attaches to the top rim of the socket (glenoid).

This tendon is subject to irritation and inflammation leading to pain. This may occur following an injury, but may also occur without any obvious cause. The pain is at the front of the shoulder and can radiate to the arm. It is worse with elbow movement and with overhead activities.

This may be an isolated condition but can be associated with impingement and rotator cuff tears.

If the condition deteriorates, it may lead to complete rupture of the long head of biceps. Once the tendon is ruptured, it retracts down the arm leading to bunching up of the muscle when contracted. Surgery is not indicated in these cases.

The diagnosis is based on history, examination and investigation. Either ultrasound scan or MRI can be performed.

Treatment of biceps tendonitis starts with rest and modifying activities. Anti-inflamatory medication (eg ibuprofen) and physiotherapy are recommended. Steroid injection into the biceps groove can be given. Finally, surgery can be performed if all else fails. This is often key hole and involves either cutting the tendon completely or cutting and reattaching it outside the joint.

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