Bicep Tendinopathy

Question 1

Biceps Tendinopathy Cause

Answer 1

• Inflammatory tenosynovitis affecting tendon of long head biceps as it travels within bicipital groove in proximal humerus
• Secondary impingement = common, relationship between this and RTC pathology (often seen together)

Question 2

Biceps Action

Answer 2

• Forearm supination and elbow flexion
• Also contributes to 10% of shoulder abduction when arm is in ER

Question 3

Biceps Tendinopathy Clinical Presentation

Answer 3

• Atraumatic, insidious onset of anterior shoulder pain
• Symptoms worse with OH activities
• Pain radiating down anterior arm from shoulder
• Clicking or popping
• Pain at rest and at night
• Pain with palpation of bicipital groove (most felt with 10 degrees of IR)

Question 4

Biceps Tendinopathy

Answer 4

• Yergasons
• Neers
• Hawkins
• Speeds

Question 5

Biceps Tendinopathy Treatment

Answer 5

• Focus on unloading of tendon, followed by reloading
• Isometric training if pain is issue, progress to eccentric, and then concentric
• Stretching and strengthening
• Ultrasounds, iontophoresis, friction massage
• Very slow heavy loading program
• Restore pain free ROM, then progress from one phase onto the next
• AAROM and mobilization
• Proper scapulothoracic rhythm
• Painful activities avoided early on