Biceps Tendinopathy What is it? Biceps tendinopathy refers to inflammation within the tendon which connects the biceps muscle on the front of the upper arm with the shoulder blade. How does it happen? Biceps tendinopathy results from overuse of the biceps tendon. The function of the biceps tendon is to transmit forces produced by the biceps muscle to the shoulder blade so as to produce or control movement at the shoulder joint. To reach its insertion onto the shoulder blade, the biceps tendon passes through a narrow groove in the arm bone. In this groove the tendon is susceptible to ‘wear and tear’. Repetitive use of the biceps muscle and, therefore, the biceps tendon can rub the tendon against the edges of the bony groove resulting in microscopic tears within the substance of the tendon. To repair these microscopic tears, the body commences an inflammatory response. This inflammation within the tendon is tendinopathy. How does it feel?
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Biceps tendinopathy results in pain felt in the top of the upper arm. This pain typically develops gradually. Initially, the tendon may only be painful following exercise. For example, it may be first felt on rising the day following participation. Associated with the pain may be stiffness or tightness in the shoulder. Typically, these initial signs of biceps tendinopathy are ignored as they disappear quickly with use of the arm or applying heat (i.e. a hot shower) over the shoulder and upper arm. However, as you continue to participate, the tendinopathy progresses and the pain within the tendon becomes more intense and more frequent. For example, it may begin to be present during participation. In the earlier stages, this pain during participation may initially disappear as you warm-up, only to return when you cool down. However, as you continue to participate, the tendinopathy worsens and Physio Professionals (07) 5438 9111
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your pain may begin to be present for longer periods during participation until it is present all of the time. This may interfere with your performance. What should you do? Biceps tendinopathy generally does not get better on its own if the cause is not addressed and you continue to exercise. If you have or suspect you have biceps tendinopathy, you should consult your physiotherapist. In the meantime you can begin initial treatment. This should consist of icing following participation. Icing may consist of crushed ice wrapped in a moist towel applied over the sore site for 15-20 minutes or ice in a paper cup massaged over the sore region until the skin is numb. What shouldn’t you do? If you have or suspect you have biceps tendinopathy you shouldn’t ignore the problem. Your pain may get better as you exercise, however, the exercise you are doing may be interfering with the healing process and causing further damage. This can lead to your injury getting worse such that your pain does not ‘warm up’ and you feel it throughout participation. If this occurs, your recovery may be prolonged and it may take a number of weeks or months for you to return to full participation. Could there be any long-terms effects? Biceps tendinopathy does not produce any long-terms effects as long as it is properly diagnosed and appropriately treated. If not, it can lead to prolonged pain in the upper arm and a prolonged lay-off from participation. Management
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The assistance of a sports physiotherapist is important in the treatment of biceps tendinopathy. Initially, they can assist in diagnosing the problem and its severity. This may require the use of imaging techniques such as ultrasound or MRI. From this, the sports physiotherapist will be able to determine an appropriate treatment plan. This may involve activity modification, soft tissue treatment such as massage and stretching, and the progression through a series of specific strengthening exercises. The sports physiotherapist will also be able to assess and determine why you developed biceps tendinopathy and address this during your recovery to prevent a re-occurrence when you return to full activity.
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