Many individuals in the greater Long Island, Brooklyn, Queens and NYC area visit Dr. Jonathan Ticker, orthopedic surgeon and shoulder specialist, because they are experiencing bicep pain and shoulder weakness. Biceps tendonitis is a common cause of these two symptoms, and is caused by inflammation of the upper biceps tendon, otherwise known as the long head biceps tendon, from overuse or the natural degeneration process.
Biceps tendonitis is characterized as the irritation and inflammation of the long head biceps tendon. This strong, cord-like soft structure is responsible for connecting the biceps muscle to the bones within the shoulder joint. This shoulder condition is quite common in the athletic population when extra strain is placed on the biceps tendon during sports activities.
Continuous overuse and degeneration of the biceps tendon are the two main culprits. Overuse and the natural aging process damage the cells and collagen fibers within the tendon making them weaker and unable to repair themselves. Over time, the tendon becomes irritated and inflamed, leading to the symptoms of biceps tendonitis.
Symptoms of Biceps Tendonitis
Biceps tendonitis is marked by biceps pain, or pain in the front of the shoulder, and weakness. The pain is often intensified when a patient extends the arm out in front of the body or raises the arm above the shoulder joint. As the condition progresses, biceps pain becomes more severe and can be felt throughout the day during many arm movements. Certain patients diagnosed with biceps tendonitis may also experience a burning sensation, swelling, redness and/or a snapping sound during arm and shoulder movements.
Diagnosis of Biceps Tendonitis
After discussing a patient’s bicep pain and other symptoms, Dr. Ticker will perform a thorough medical review and physical examination. During the examination, he will assess the affected shoulder’s range of motion, signs of instability, areas of tenderness, and overall strength. A series of x-rays is usually indicated. An MRI scan may also be performed to rule out other potential injuries and to confirm the biceps tendonitis diagnosis.
Treatment of Biceps Tendonitis
Biceps tendonitis is typically treated with non-surgical, conservative measures. Dr. Ticker commonly recommends a combination of rest, ice, anti-inflammatory medications (NSAIDs), and a physical therapy program. A selective steroid injection may be both diagnostic and therapeutic.
In cases of severe damage to the biceps tendon, Dr. Ticker may recommend an arthroscopic shoulder surgery. The surgical approach varies for each patient depending on tendon damage severity. In some cases, a biceps tenodesis is performed. This approach requires Dr. Ticker to remove the damaged section of the biceps tendon and then reattach the remaining tendon to the upper arm bone (humerus). Removing the painful part of the biceps tendon from the shoulder usually alleviates bicep pain and shoulder weakness, and restores full joint function. In severe cases, the long head of the biceps tendon may be so damaged that it is not possible to repair it. Dr. Ticker may elect to release the damaged biceps tendon from its attachment site with a procedure known as a biceps tenotomy.
For additional resources on bicep pain and shoulder weakness, or for detailed information on biceps tendonitis treatment, please contact the Long Island, Brooklyn, Queens and NYC area orthopedic office of Dr. Jonathan Ticker.