Bicep Tendonitis Information

Bicep tendonitis is a condition that affects the area where the bicep muscle meets the front of the shoulder. Bicep tendonitis, often referred to as bicipital tendonitis, rarely occurs on its own. It usually develops as a result of shoulder or rotator cuff tendonitis. Unfortunately, bicep tendonitis is a very common condition amoungst athletes and often is ignored in its early stages and develops into a serious condition.

About the Bicep Tendon

The bicep muscle is situated in the front of the upper arm and is responsible for extanding your arm outwards. It also helps accelerate the arm in overhead movement like throwing or playing racket sports. The bicep tendon is a long cord-like structure that connects the bicep muscle to the shoulder at the top and to the radius at the bottom. Bicep tendonitis mostly occurs in the top tendon (connecting to the shoulder), but in some cases may affect the bottom tendon. See the image below for a bicep tendon diagram:

Bicep Tendonitis Causes

There are four main causes of bicep tendonitis. (1) Repetition and overuse (2) Calcifications into the tendon (3) Multidirectional instability (4) Direct trauma. In many cases bicep tendonitis is developed as a result of a shoulder condition. In these cases extra strain is placed on the bicep tendon causing inflammation.

Bicep Tendonitis Symptoms

There are several significant warning signs to look out for if you think you may be developing bicep tendonitis. Some of the symptoms include the following:

1. Pain in the front of the shoulder when you move your arm and shoulder. This pain will especially be felt when you extend your arm out in front of you or raise your arm above your shoulder.
2. You feel pain when the front of the shoulder is touched.
3. The are may be red and swollen. In some cases you may feel a burning sensation around the area in the front of the shoulder.
4. The pain is often worse at night or first thing in the morning.
5. You may feel or hear a snapping sound when you move the arm or shoulder in certain directions.

When bicep tendonitis first develops, the pain will only be slight and localized to the front of the shoulder. The pain may only be during and after exercise. As bicep tendonits develops further the pain may become more severe, spread over a larger area and be felt throughout the day.

How to Diagnose

If you develop any of the bicep tendonitis symptoms mentioned above you may have the condition. It is possible to self-diagnose in the early stages of bicep tendonitis, when only rest is needed to heal the condition. However, it is recommended that you consult a sports doctor or GP to have bicep tendonitis accurately diagnosed.

The doctor will examine your bicep muscle and shoulder for signs of tenderness and inflammation. He/She may then order some tests such as X-rays, MRI or ultrasound.

Treatment Options

Bicep tendonitis is treated by resting the affected area and slowly working back into movement and exercise. Here are some of the bicep tendonitis treatments you should try:

1. Initially, the affected area must be rested and removed from activity of any kind. This may involve using a sling for the arm.
2. All overhead exercises and movements must be avioded.
3. Apply ice to the area every 4 hours, for 2-3 days or until the pain subsides. (Ice is also helpful for minimizing pain directy after exercise)
4. Take anti-inflammatory medication as prescribed by your doctor.
5. In severe cases, you may need to get a corticosteroid injection from your doctor. This will help to redure severe pain.
6. You should rest the area for at least 3 weeks. After 3 weeks you can start on some light stretching and rehabilitation exercises (see below)

The best treatment for becip tendonitis is rest. In most cases, the condition will heal after about 3-6 weeks rest and you will be able to ease back into exercise.

Rehabilitation Exercises

Once you have rested your bicep for at least 3 weeks you will need to ease it back into activity. Here are a few rehabilitation exercises you can do for your bicep tendon:

1. Bicep Stretch
   Stand facing a wall (about 6 inches away from the wall). Raise your arm out to your side and place the thumb side of your hand against the wall (palm down). Keep your elbow straight. Rotate your body in the opposite direction of the raised arm until you feel a stretch in your biceps. Hold 15 seconds, repeat 3 times.
   
2. Light Weight Curls
   Stand straight up with a light weight in your hand and your palm facing upwards. The light weight can be something like a soup can or 1kg dumbbell. Slowly curl the weight up to your shoulder. Pause for a count of 1 and lower the weight back to the starting position.
3. Shoulder Flexing
   Stand with your injured arm hanging down at your side. Keeping your elbow straight, bring your arm forward and up toward the ceiling. Hold this position for 5 seconds. Do 3 sets of 10. As this exercise becomes easier, add a light weight.

You should aim to do these exercises once or twice a day. If you feel that the affected area has healed enough, you can ease back into overhead activity. You must make sure you warm up correctly, stretch and take it easy for a while.

Prevention

Prevention of bicep tendonitis is simple. You should always warm up the area before exercise, don't overdo it, and stretch and cool down after exercise. If you do feel a slight pain in the upper biceps area, apply some ice immediately to help ease the pain and reduce inflammation.

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