A biceps tendon injury is a fairly common shoulder condition typically caused by repetitive overuse or a traumatic event. An injury to the biceps tendon is characterized as a problem with the tendon that connect the muscle in the upper arm’s front portion to the bones in the shoulder or elbow. Common injuries include subluxation, dislocation and a torn biceps. Shoulder specialist and orthopedic surgeon serving the greater Long Island, Brooklyn, Queens and NYC area, Dr. Jonathan Ticker specializes in numerous injuries to the shoulder joint, including biceps tendon injuries.
The biceps muscle is located at the front of the arm and plays an important role in rotating the wrist and flexing the elbow. Two tendons, the long head and the short head, attach the upper portion of the biceps muscle to the shoulder. The long head tendon is most commonly associated with shoulder injuries since it attaches directly to the labrum and passes through a groove to inside the shoulder joint.
A biceps tendon injury can occur suddenly during a traumatic event that twists or tears the tendon, such as lifting a heavy object or falling onto an outstretched arm. Overuse of the tendon, often associated with the athletic community, is another common cause of a torn biceps, a dislocation or a subluxation.
Common injuries to the biceps tendon include:
- Torn biceps- A partial or complete tear of the tendon may occur at its attachment site to the shoulder joint.
- Biceps tendon subluxation- A subluxation occurs when the soft tissue restraints become injured, allowing the tendon to partially dislocate in and out of its groove.
- Biceps tendon dislocation- Beyond a subluxation, a dislocation occurs when the tendon completely dislocates in and out of its groove.
Symptoms of a Biceps Tendon Injury
Biceps tendon injury symptoms vary depending on each injury. Patients with a torn biceps report sudden and severe pain at the shoulder joint, weakness, difficulty rotating the arm and a “popping” sensation. Patients with a subluxation or dislocation report similar symptoms, as well as a “clunking” sound when rotating the arm outward or inward.
Diagnosis of a Torn Biceps or other Bicep Tendon Injury
If a torn biceps, subluxation or dislocation is expected to be the cause of shoulder pain and loss of function, Dr. Ticker will perform a thorough medical review and physical examination. Subluxation or dislocation often indicates injury to adjacent structures, such as the subscapularis tendon attachment. A series of x-rays and an MRI scan will also be performed to determine the extent of tendon damage and to confirm the diagnosis.
Treatment of a Biceps Tendon Injury
Conservative treatment is typically the preferred approach if the biceps tendon injury involves a minor tear of the biceps or a limited subluxation. Both injuries are treated with rest, ice, modified activities and anti-inflammatory medications (NSAIDs). A physical therapy program is prescribed by Dr. Ticker in many cases to help regain flexibility and strength in the injured joint.
A severe or complete torn biceps, as well as a tendon dislocation, may require surgery. A torn biceps can be repaired in a minimally invasive approach where Dr. Ticker re-attaches the torn tendon back to its attachment site on the bone. If a small portion of the tendon is damaged, a debridement (shaving) of the torn fibers may be performed. If a large portion of the tendon is damaged, a biceps tenodesis may be necessary. This surgical procedure is often the preferred choice in cases of a dislocation as well. In cases of a torn biceps, Dr. Ticker will remove the torn tendon stump from inside the shoulder joint and then attach the remaining tendon to the humerus (upper arm bone). In cases of a dislocation, Dr. Ticker will stabilize the long head biceps tendon within its groove using drill holes, suture anchors or sutures into the bone or soft tissue. A biceps tenotomy may also be a treatment consideration.
For more resources on a biceps tendon injury, such as torn biceps, a subluxation or a dislocation, please contact the Long Island, Brooklyn, Queens and NYC area orthopedic practice of Dr. Jonathan Ticker.