The bicep muscle is located in the front of your upper arm. It helps stabilize the upper arm bone (humerus) in the shoulder socket. It also helps accelerate and decelerate the arm during overhead movement in activities like tennis or pitching. Strong, cord-like structures called tendons connect the biceps to your lower arm and shoulder. If those tendons become inflamed or irritated, the condition is called tendinitis.
Overuse, aging, and stress can cause the biceps’ tendons to deteriorate. Repetitive overhead activity can often be blamed for these injuries.
Bicep tendonitis is commonly associated with:
- Pain when the arm is bent or overhead
- Localized tenderness as the tendon passes over the groove in the upper arm bone
- Occasionally, a snapping sound or sensation in the shoulder area
During a physical examination, your doctor will assess the shoulder area for range of motion, tenderness, and signs of shoulder instability. You may be asked to raise or rotate the arm. Your doctor may request an X-ray to uncover associated conditions that might cause irritation. An MRI might also be requested to check for any damage to the tendons.
Initial treatment is conservative. The first step is to rest the arm and shoulder. Switch to another sport or activity for awhile. Ice applications and nonsteroidal anti-inflammatory medications such as ibuprofen can help reduce inflammation. Your doctor can also recommend stretching and progressive strengthening exercises to build muscle endurance and restore range of motion. Ideally, you can gradually return to overhead activity.
If the pain results from shoulder instability or from pressure on the tendon from the shoulder bones, your orthopedic surgeon may recommend arthroscopic surgery. Using fiber optic technology and miniature instruments inserted through a small incision, the surgeon can examine the shoulder joint and anchor the tendon properly.
After surgery, a rehabilitation program will be prescribed that includes stretching and strengthening exercises. Early movement is important, but you should wait for approval before doing any heavy lifting or returning to sports.
Reproduced with permission Fischer S., (interim ed): Your Orthopaedic Connection. Rosemont, Illinois. Copyright American Academy of Orthopaedic Surgeons.