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Biceps tendinopathy refers to pain or injury that affects one of the bicep tendons in the shoulder. This may be an inflamed tendon, an inflamed tendon sheath, a degenerative condition, or a ruptured tendon. Biceps tendinopathy can be caused by a range of issues including tendon impingement, overuse, trauma, or shoulder instability. That means that it typically coexists with other shoulder problems such as rotator cuff tears. It is commonly seen in athletes such as swimmers and gymnasts as well as workers who do a lot of heavy lifting and overhead shoulder work.

Symptoms of biceps tendinopathy

People with biceps tendinopathy commonly report pain in the anterior shoulder region; this pain may radiate down the arm to the elbow. The pain may worsen with overhead activities, particularly positions that combine external rotation and abduction such as cocking to throw. Flexing the shoulder or elbow forearm supination may also exacerbate pain. Some patients experience muscle weakness as well as snapping or clicking when they move their shoulders. Symptoms may be alleviated with rest and ice. Your physical therapist can diagnose biceps tendinopathy based on your symptoms as well as a clinical examination, usually including ultrasonography or MRI.

Treatment of biceps tendinopathy

Treatment depends on the type of tendinopathy present and must also address the cause of the condition. Inflammatory biceps tendinopathy often responds favorably to non-steroidal anti-inflammatory medications or cortisone injections. Ice can also help reduce swelling and relieve pain. Non-inflammatory types are unlikely to react to these measures but may respond well to special strengthening exercises your physical therapist can advise. In the case of a ruptured tendon, surgery is often the best route. In all cases, pain relief is an essential component of treatment. The first and most important thing to do to help relieve pain is to rest the area and avoid any movements that cause pain. Taping the shoulder may also provide some pain relief as well as sleeping in a relatively upright position. Ice is also helpful as are special exercises and therapies provided by your physical therapist.

Prognosis of biceps tendinopathy

Patients with biceps tendinopathy often experience complete healing and recovery and can return to their normal activities. Even ruptures do not always require surgery and may respond well to rehabilitation. In general, inflammatory types are quicker to respond to treatment than degenerative types. The time it takes to recover can vary widely depending on the cause of the issue. When you can return to your job or chosen sport depends on many factors. Depending on the demands of your activities, you may need sport-specific or job-specific exercises to help you achieve a safe return. Your physical therapist can discuss your individual needs and goals of treatment with you and help you understand what to expect.

Each case of biceps tendinopathy is unique and involves a range of factors. It’s important to be closely monitored by your physical therapist to ensure that you are progressing at a safe rate that protects you from frustration and re-injury as you heal.


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