Anatomy of the shoulder

The Condition

The long head of the biceps tendon runs in a groove at the front of the shoulder (the bicipital groove). The tendon can become inflamed and damaged either through overuse (weightlifting and overhead sports) or simply with time

What are the signs and symptoms?

The patient usually complains of a pain in the front of the shoulder. The tendon is usually tender to touch adn the pain is made worse with overhead activities and exercises which load the biceps muscle.

How is the diagnosis made?

The doctor will take a full history and examine the shoulder and arm. Ultrasound can often reveal fluid around the tendon and damage within the tendon. MRI can is occasionally used and can help to rule out other problems inside the joint.

What is the initial treatment?

The initial treatment is symptomatic and includes rest and anti-inflammatories.An ultrasound guided steroid injection around the tendon in the groove may be suggested. This does not always solve the problem but can be useful in confirming the diagnosis.

If initial treatment doesn’t work, what’s next?

The patients may complain of a persistent ache in the front of the arm, made worse by lifting or carrying.

If the symptoms are intrusive enough then biceps tenodesis may be necessary.