Introduction:

The biceps muscle has two tendons at the shoulder. The long head inserts at the top of the socket and the short head inserts adjacent to the socket on the coracoid process of the scapula. Tendonitis occurs most commonly in the long head of the biceps tendon. A debate persists regarding the role of the long head of the biceps in the function of the shoulder. Inflammation is caused by micro tears in the tendon generated by overuse or exceeding the strength of the tendon. Repetitive motion such as throwing, serving, or swinging a golf club can predispose to these micro tears and inflammation.

Biceps tendinitis is inflammation of the tendon around the long head of the biceps muscle.

Causes:

* General wear and tear.

* Overuse of a tendon in a repetitive motion.

* Poor posture.

* Lifting something heavy.

* Poor technique while playing sports.

* Injury.

* Shoulder impingement.

Risk factors:

* Poor Repetitive overhead activity either in sport, work, or daily life.

* Tendon becomes stiffer as we age and more prone to injury.

* Arthritis, which causes bone spurs that can encroach upon the biceps tendon.

* Smoking.

Symptoms:

* Pain when you move the upper part of the arm (shoulder or elbow).

* Weakness.

* Tenderness.

* A clicking, grating, or snapping sensation with movement of the shoulder.

* Swelling in the area, often co-occurring with heat or change in skin color.

* Difficulty rotating the arm.

Diagnosis:

Physical examination:

* Taking a person’s medical history and discussing symptoms will enable a doctor to diagnose bicep tendonitis.

* They may ask a person to demonstrate the limit of the mobility in the affected arm and compare it with that of the other arm.

Special test :

**Hawkins test:

* The patient flexes the elbow to 90 degrees while the physician elevates the patient’s shoulder to 90 degrees and places the forearm in a neutral position.

* With the arm supported, the humerus is rotated internally. The test is positive if bicipital groove pain is present.

*Speed test:

* He patient tries to flex the shoulder against resistance with the elbow extended and the forearm supinated .

* A positive test is pain radiating to the bicipital groove.

*Radiology Findings:

* MRI scans: This scan type can show any tears of the tendon and enable doctors to clearly assess the injury.

* X-rays: These cannot show soft tissues, such as tendons, but they can help rule out other causes of the symptoms a person is experiencing.

Treatment:

* Pain-relief medications.

* Physiotherapy:

* Taping Over Biceps Muscle For Stabilizing Purpose And Helps to Relieve Pain Free Movement.

* Rest; stretching exercises of the scapula, rotator cuff, and posterior capsule.

* The goal of stretching is to regain a balanced range of motion without stiffness or pain in any position.

* Strengthening and a progressively difficult throwing exercise program.

* The patient may start exercises after the shoulder is pain-free.

Surgical.

Prevention:

* Stretch before activity.

* Take breaks when doing continuous overhead activity.

* Strengthen your shoulder muscles especially the rotator cuff.

* Maintain your range of motion of your shoulder.

* Avoid nicotine.

Source: Courtesy of mayoclinic.org