Biceps tendonitis
Synonyms
Tendonitis
definition
The term "biceps tendonitis" means the presence of inflammatory processes in the area of the biceps tendon. In most cases, these inflammatory processes affect the long tendon of the two-headed muscle. So it is not exactly a muscle inflammation.
introduction
The biceps (Biceps brachii muscle) is a skeletal muscle in the area of the Upper arm. It is made up of two different ones Muscle heads (long head and short head; Caput longum et breve) composed. These two muscle heads arise in different places of the Shoulder blade and unite in middle section of the upper arm into a single muscle belly.
The biceps is especially important Supination of Forearm (Rotation of the forearm so that the thumb rotates around the hand from the inside out) involved. In addition, the arm can be moved away from the body when the long biceps head is isolated.Abduction). If both heads of the muscle contract at the same time, the arm is moved forward from the basic position (Anteversion). In addition, the biceps is on the Internal rotation of the arm involved.
Due to the sometimes heavy loads that act on the biceps, various diseases are particularly common in the area of this muscle. Above all, the long tendon is subject, due to its course by the Shoulder joint, a special mechanical load. For this reason, the long biceps tendon is at risk of Development of painful fraying or entrapment. In addition to the particularly widespread Biceps tendon rupture (Tear of the biceps tendon), can be a Biceps tendonitis be provoked.
Other risk factors for developing biceps tendonitis are Posture and movement errors, old age and diseases of the shoulder joint. People who have had pain in the area for a long time shoulder and the upper arm should definitely consult a specialist as soon as possible. Only through the early diagnosis and the initiation of suitable treatment can consequential damage in the area of the Biceps tendon be prevented.
Appointment with a shoulder specialist
I would be happy to advise you!
Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of .
The shoulder joint is one of the most complicated joints in the human body.
The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.
causes
If a biceps tendon inflammation develops, the long tendon of the muscle is affected in around 90 percent of cases. In contrast, inflammatory processes in the area of the short biceps tendon are comparatively rare. In addition, it can be observed that biceps tendonitis usually affects the dominant arm.
Biceps tendon inflammation of the long tendon of the muscle is associated with wear and tear in most cases. People who regularly play throwing sports (such as baseball or handball) are at increased risk of developing biceps tendonitis. In addition, biceps tendonitis can often be seen in strength athletes and / or golfers. The reason for this is the long-term overloading of the biceps tendon. A previous damage to the long biceps tendon, which can become tired after a certain period of time in a biceps tendonitis, is also caused in many cases by a sudden trauma. In particular, severe falls or blunt violence in the area of the shoulder joint can attack the tendon structure and encourage the development of biceps tendonitis.
Inflammatory processes in the area of the short tendon of the muscle, however, often arise for no apparent reason. In medical terminology, this is known as idiopathic biceps tendonitis.
Another typical cause for the occurrence of inflammatory processes in the area of the long biceps tendon is the so-called "impingement syndrome". This condition causes a narrowing within the shoulder joint. Especially when the arm is raised to the side, the humerus is brought too close to the roof of the shoulder. In this way, the long tendon of the muscle is regularly exposed to significant stress. Biceps tendonitis can also develop in the acute phase of so-called "frozen shoulder" or in rheumatoid shoulder diseases.
Please also read our article on this Tendinitis in the arm
Symptoms
In the presence of biceps tendonitis, the typical Signs of inflammation to be watched. The affected patients usually feel it quite early dull and / or stabbing pain at the Front of the shoulder. This pain often radiates to the neck and upper arm. Furthermore, in a direct side comparison of both arms on the shoulder affected by the inflammatory processes, a significant overheating be perceived. Swelling and redness occur due to the relatively deep course of the biceps tendons only in particularly pronounced cases of illness.
People who suffer from biceps tendonitis can usually only move the affected arm to a limited extent or not at all. Occasionally, when trying to lift the affected arm sideways, a snap, jump or crack can be heard.
diagnosis
The diagnosis of the Biceps tendonitis involves several steps. At the beginning there is usually a extensive Doctor-patient conversation (anamnese), in which the patient concerned should describe the symptoms in as much detail as possible. The symptoms already felt by the patient provide an initial indication of the presence of a biceps tendonitis.
This is followed by a orienting physical examination in side-by-side comparison. If a biceps tendonitis is suspected, the doctor will start with one Inspection of the shoulders and arms. He pays particular attention to this Misalignments, skin symptoms (e.g. redness), Wounds and scars. The actual examination then begins. There are a number of special examinations that can help diagnose pathological changes in the long biceps tendon. Due to the causal diseases, a patient who suffers from biceps tendonitis usually shows one significant restriction of movement of the shoulder joint.
In addition, play mainly imaging procedures plays a decisive role in the diagnosis of biceps tendonitis. With the help of a Ultrasound examination (Sonography), thickening and accumulation of fluid in the area of the long biceps tendon can be shown.
In addition, the implementation of a Magnetic resonance imaging of the shoulder (short: MRI) of the affected shoulder help diagnose biceps tendonitis.
A MRI of the shoulder In addition to the quality and inflammation of the biceps tendon, damage to the rotator cuff, cartilage damage in the shoulder joint and other pathological processes can also be made visible.
Read more about this: MRI of the shoulder
Duration of biceps tendonitis
Biceps tendon infections can be from very different duration be. If you feel pain after a strenuous exercise or any other special strain on your shoulders, this pain can be relieved quickly with cold applications and immobilization and the inflammation can be nipped in the bud.
Is the inflammation (un) noticed more advanced, it can also be over weeks to months keep away and, depending on the treatment / immobilization, always cause new problems. Completely immobilizing the shoulder region is very difficult in everyday life and returning to sporting activities too early can lead to the inflammation recurring.
Find one operative therapy instead, after the operation, a stress-free period of at least 2 weeks and one Full load on the shoulder only after 8-12 weeks can be assumed.
treatment
Treatment of biceps tendonitis depends primarily on the underlying cause. Acute complaints caused by the inflammatory processes in the muscle tendon can be alleviated by taking pain relievers. Especially pain relievers (Analgesics), which have the active ingredients paracetamol or ibuprofen, are particularly suitable for alleviating the symptoms of biceps tendonitis. Since the active ingredient ibuprofen has both pain-relieving and anti-inflammatory properties, it should be preferred to take it.
In addition, local cold applications can help alleviate the acute symptoms of biceps tendonitis. Patients who suffer from particularly pronounced symptoms can treat the affected shoulder with the help of a cooling pad or cooling pad. In this context, however, it must be ensured that the coolant must never be placed directly on the surface of the skin. Otherwise, the skin and the tissue immediately below the surface of the skin can be damaged by the cold.
The use of heat patches is strongly advised against in the presence of biceps tendonitis. Warmth usually ensures that the inflammatory processes spread further and that the symptoms felt by the patient increase in intensity.
Further treatment for biceps tendonitis is usually carried out with various elements over a period of three to six months. Regular participation in physical therapy exercises in particular plays a crucial role in the treatment of biceps tendonitis. Injecting local anesthetics and cortisone preparations near the affected biceps tendon can also help accelerate the healing process.
Local massages of the shoulder region and the upper arm are also typical treatment measures for patients suffering from biceps tendinitis. In addition, biceps tendinitis can be treated with a large number of the causal diseases through the local application of ultrasound waves or stimulation currents.
In the case of a biceps tendon inflammation that has developed in the course of the impingement syndrome, surgical correction of the shoulder joint must be carried out in many cases. Patients with biceps tendinitis should take great care not to put weight on the affected arm for a while. Sports activities should generally be stopped until the inflammatory processes have healed completely. Failure to do so can lead to serious complications, which means that surgical tendon transection must be considered.
physical therapy
With inflammation of the Biceps tendon there are different physiotherapy treatment options. One of them is the conservative therapy through physiotherapy. The aim of therapy is to restore the full range of motion and Freedom from pain in the shoulder joint.
The physiotherapeutic treatment includes among other things Exercise for the shoulder muscles. The patient should be introduced to exercises that serve to build muscle in the shoulder area. In the long term, these exercises should be carried out on your own regularly to help you Muscle gain to allow in the shoulder girdle.
They play Rotator cuff muscles play an important role, as they guide the shoulder blade and can only help to relieve the biceps tendon if it is functional. Also the Triceps is important at this point.
The mobilization of the corresponding muscles can be carried out passively by the therapist, actively by the patient or a mixture of both.
Is it a tendinitis caused by overuse, is primarily used during physiotherapeutic treatment Relief of the shoulder joint, accompanied by pausing physical activity, in the foreground.
Voltaren for biceps tendonitis
There are currently various Voltaren® products on the market that differ in the type of application and dosage.
What they all have in common is the active ingredient diclofenac, which is an anti-inflammatory (anti-inflammatory) Is a substance that primarily provides pain relief and anti-inflammatory effects.
Read more on the subject at: Voltaren®
In the case of biceps tendonitis, applying a Voltaren® ointment is therefore very helpful to relieve local symptoms of inflammation such as redness, swelling and overheating, but also pain.
Depending on the intensity of the complaints and depending on the product properties (Voltaren pain gel® or Voltaren pain gel forte® etc.), the ointment should be applied to the affected area in the area of the long biceps tendon.
The Voltarensalbe® should be spread generously over the respective shoulder joint, as this is where the tendinous parts of the muscle are located, which cause the symptoms in the event of inflammation. The muscle pulls along the upper arm to where it begins at the ulna. If necessary, the ointment can also be rubbed into the muscular areas because of the pain caused by the sinewy parts.
The exact dosage and application should be taken from the respective package insert. In principle, the ointment can be applied several times a day.
Exercise for biceps tendonitis
After biceps tendonitis is one physiotherapy treatment in addition to the application of pain reliever and anti-inflammatory ointments, it is essential to get a full Functionality and to gain regeneration of the injured tendon.
A common therapeutic application is the so-called Transverse friction. This is intended to be a Pain reduction with a simultaneous gain in increased mobility.
The friction, i.e. friction, should take place across the length of the tendon. With the help of the fingers, the tendinous part is preferably massaged in the case of a biceps tendon inflammation, without the affected person feeling pain.
This is to make it Promotion of local blood circulation come. With other indications, this method can Tension or hardening be solved.
It is important to know that the Transverse friction may only be used if the biceps tendon is inflamed. Calcification of the biceps tendon at the base is a contraindication.
Stretching for biceps tendonitis
Treatment for biceps tendonitis looks next to that drug therapy, pain relieving therapy as part of a physiotherapy and previous Gentle the affected biceps tendon special stretching exercises in front.
Biceps tendonitis should not be stretched until the acute symptoms in the form of pain, redness and overheating have subsided.
In the following, three exercises are to be explained as examples for stretching the biceps tendon after an inflammatory disease.
- In the first exercise, stand with the side of the affected shoulder against the wall or a door frame. The affected arm is stretched backwards parallel to the floor and pressed lightly against the wall or the edge of the door until you feel a stretch.
- The arm of the affected side is stretched out forwards and parallel to the floor, the palms of the hands facing upwards so that the palm of the hand can be pressed slightly towards the floor with the other hand.
- Both arms are brought together behind the back and the hands are placed one inside the other so that the palms point downwards. Now the arms are stretched away from the body towards the ceiling until a stretch can be felt in the biceps.
The stretching exercises should all be held for about 20-30 seconds and repeated several times if necessary. It is important to mention that stretching exercises are generally more suitable for the muscular part of muscles and not for the sinewy part. Nevertheless, the stretching exercises have a positive effect on the therapy of biceps tendonitis.
Swimming if you have a biceps tendonitis
Swimming is one of the sports that can lead to injuries such as biceps tendonitis. The biceps has its origin with the long and short biceps tendons in the area of the shoulder joint, so that a biceps tendonitis is closely related Inflammation in the shoulder joint is connected.
When swimming, the shoulder joint is actively used, so that excessive or improper stress can lead to inflammation of the biceps tendon.
While swimming can be a trigger for biceps tendonitis, swimming can potentially also act as a low-stress sporting activity to Maintaining mobility in the shoulder joint serve.
The biceps are involved in the movement sequence when swimming, but the load in this case is not comparable to that Lifting weights to build muscle in the biceps.
In addition, when swimming there is no forced Flexion in the elbow joint taken, which in turn suggests trying to slowly get used to movements in the form of swimming after a biceps tendonitis.
In general, it is up to the individual to decide whether the pain intensity allows for moderate swimming or not. However, it is important not to immobilize the joint, but rather to protect the origin of the biceps tendon in the shoulder joint.
Complications
Biceps tendonitis should must be diagnosed promptly and be treated. Pronounced inflammatory processes that are mainly present in the area of the long tendon of the muscle can otherwise lead to serious complications. The most common complication that occurs in connection with a biceps tendonitis is the so-called "Biceps tendon rupture“(Torn biceps tendon).
forecast
Although biceps tendinitis can be quite persistent and in many cases lasts for several weeks to months, the prognosis for this condition is comparatively good.With prompt diagnosis and prompt initiation of suitable therapy, biceps tendinitis usually heals without any consequential damage.
cure
Inflammation of the biceps tendon can develop completely back up. The healing process may take a long time, but is usually possible. The underlying problem of inflammation is important for the healing process in order to select the right treatment options.
If there is an anatomical change or incorrect posture in the shoulder region that leads to irritation of the biceps tendon, a surgical intervention be necessary for the healing of the inflammation, otherwise the inflammation will always recede when physical exertion resumes.
If the inflammation is due to increased stress, you can conservative therapies such as physiotherapy, ultrasound and Immobilization lead to the healing of the inflammation.
