Biceps Tendon Disorders

There are several types of biceps tendon disorders. Biceps tendinitis occurs when the tendon becomes inflamed, most often the long head of the tendon at the shoulder. Over time, inflammation can lead to tendinosis, a degenerative condition where the tendon fibers weaken.

• Partial tears happen when only some of the tendon fibers are damaged, which may cause pain and weakness without a complete rupture.
• Complete tears, or ruptures, may occur in the shoulder (proximal) or at the elbow (distal). These injuries often cause sudden pain, bruising, and sometimes a bulge in the upper arm known as a “Popeye deformity.”
• Another condition is tendon instability, when the tendon slips out of its normal groove in the shoulder, sometimes causing a snapping or popping sensation.
• Disorders such as SLAP tears, rotator cuff tears, or shoulder arthritis can also involve the biceps tendon and complicate the condition.

Symptoms of biceps tendon disorders vary depending on the type of problem, but there are several common signs.

• Many patients experience pain or tenderness in the front of the shoulder, especially when lifting the arm overhead or reaching behind the back.
• Pain may radiate down the upper arm and sometimes worsens at night or during rest after activity.
• Weakness in the arm is another common symptom, especially with movements like bending the elbow or rotating the forearm.
• A snapping or popping sound may be heard with tendon instability. In cases of a complete rupture, patients often feel a sudden sharp pain and may notice swelling, bruising, and a bulge in the arm where the muscle has retracted.

The causes of these tendon disorders can be traced to several factors:

• Overuse from repetitive overhead activities such as throwing, swimming, or lifting is one of the most common causes. Athletes and workers who frequently use overhead motions put repetitive stress on the tendon, raising their risk.
• Age-related wear and tear also plays a major role, as tendons lose elasticity and become more prone to injury over time. Middle-aged and older adults are more likely to experience degenerative changes in the tendon.
• Shoulder conditions like rotator cuff tears or arthritis can increase stress on the biceps tendon. A history of shoulder injuries, including rotator cuff tears or labral injuries, also predisposes someone to tendon damage.
• Acute trauma, such as lifting something heavy or falling, may lead to partial or complete tears.
• Mechanical irritation can also occur if the tendon rubs excessively within the shoulder groove or becomes unstable.
• Other risk factors include smoking, which reduces blood flow and healing capacity, and medical conditions such as diabetes that affect tendon health.
• Steroid use can weaken tendons, while a high body mass index or sudden bursts of strenuous activity may overload the tendon and cause injury.

Diagnosis of biceps tendon disorders begins with a careful medical history and physical exam. Patients are asked about the onset of symptoms, whether there was an injury, and which activities make the pain worse. During the exam, your Ortho Illinois orthopedist will check for tenderness along the front of the shoulder, test range of motion, and evaluate strength when bending the elbow or rotating the forearm. Special maneuvers are used to see if the tendon causes pain or instability. In cases of suspected rupture, the arm may show obvious deformity. Imaging tests are often used to confirm the diagnosis.

Ultrasound will be used to evaluate tendon structure and movement, while MRI scans give detailed images of the tendon and surrounding tissues, including possible rotator cuff or labral tears. X-rays do not show tendons directly but can reveal bone changes or arthritis that may contribute to the problem.

Ortho Illinois provides expert care for biceps tendon disorders, from early inflammation to more complex tendon tears. By combining experience, comprehensive evaluation, and the latest treatment options, Ortho Illinois helps patients regain strength, reduce pain, and restore function in the arm.