The biceps has 2 tendons at the top end near the shoulder. The ‘long head of biceps’ (LHB) tendon travels through a groove in the humerus, curves over the top and attaches to the top of the glenoid (socket).
This course makes the long head of Biceps tendon vulnerable to irritation and inflammation with movement. This presents with pain over the front of the shoulder but radiates to the arm.
This may present as an isolated lesion but may also be associated with impingement syndrome.
If progresses, it may lead to rupture on the LHB tendon. Once ruptured, the tendon will retract down the arm causing a change in the shape of the biceps (Popeye sign).
The treatment for biceps tendinitis is usually non-operative with analgesia, rest and activity modification. Steroid injections can be given into the tendon sheath under ultrasound guidance. The few that are resistant to conservative management, may be treated surgically. Surgery is rarely indicated once the tendon ruptures.