Biceps Tendinitis and Injury

Anatomy of the Biceps

The Biceps Brachii (commonly called the biceps) is a muscle located at the front of the upper arm and attaches your arm bone (humerus) to your shoulder. It is the muscle that bumps up when you flex your arm and it functions to rotate your arm from pronation to supination (twist your palm upward), and to bend your elbow and shoulder.

Biceps means 'two heads' in latin and the muscle earns its name because it joins at the shoulder in 2 places with 2 different 'heads', know as the proximal biceps tendons because they are closest to the top of the arm. The short head of the biceps tendon originates at the coracoid process of the scapula (shoulder blade). The long head of the biceps originates just above the glenoid fossa (joint cavitiy) of the scapula (shoulder blade) and runs in front of the head of the humerus along the bicipital groove, like a rope through a pulley. The transverse humeral ligament runs over top of the long head biceps tendon, holding it against the humeral head. The 2 heads of the biceps then merge and go down the length of the upper arm. It attaches at the largest part of the radius (lower arm bone) at the elbow.

Both heads of the biceps muscle are attached to the shoulder bones with their respective tendons. These tendons can become irritated and inflamed from a strain or over use of the tendon. As a result, tendonitis, tenosynovitis or a biceps tendon rupture may occur.

Biceps Injuries

Biceps brachii tendon damage, inflammation, strain, or a tear typically affects the long head tendon of the biceps, as it is much more involved with the biceps group of muscles and tendons. The biceps is a commonly injured area of the body due to the large range of motion and frequent use of the shoulder joint.

Biceps tendinitis, or bicipital tendinitis (also spelled tendonitis), is a painful condition that affects the fibres of the biceps brachii tendon. Tendinitis occurs when the biceps tendon experiences small tears, is irritated, and becomes inflamed. As tendonitis develops, the tendon shealth (covering) can become thicker due to the tough scar tissue that builds up during healing. This thickening makes the tendon less flexible and prone to further injury.

Biceps tendonitis causes pain in your arm and/or shoulder and may lead to more severe problems if left untreated. The tendon and its sheath can become bound together, a condition known as adhesive tenosynovitis, which can severely restrict the range of motion within the arm and shoulder. The walls of the tendon sheath can thicken which prevents the tendon from sliding through the opening that keeps it in place, a condition known as constrictive tenosynovitis. The bicep tendon can rupture, or tear, completely which may require surgery.

Biceps tenosynovitis is a common tendon injury that typically affects older athletes. The synovial sheath (outer covering) of the biceps brachii tendon becomes inflamed and swollen. This limits the biceps tendon's ability to slide through the sheath smoothly and can cause scar tissue to build up between the tendon and its sheath restricting movement even more.

Symptoms of Biceps Tendon Injuries

If you have biceps brachii tendonitis or tenosynovitis you may experience:

• Pain and tenderness at the front of the shoulder that may move down the upper arm.
• Pain that increases when lifting your arm out front or above the shoulder.
• Pain that often gets worse at night or upon awakening in the morning.
• Redness, swelling, and a sensation of heat in the area of the biceps tendon.
• Limited range of motion in the shoulder and the elbow.

With tenosynovitis you may also experience:

• A sticking feeling in the upper arm/shoulder.
• A crackling noise (crepitation) in the shoulder when the arm is moved as the tendon tries to move through the sheath.

With a biceps tendon rupture:

• You may hear or feel a snap at the top of the shoulder with sharp pain. When this occurs, pain in the shoulder may quickly disappear as the pull causing strain in the head of the biceps is reduced.
• Bruising midway down the arm to the elbow may be evident.
• A bulge at the bottom of the biceps is usually noticable.
• There will be weakness when you try to lift your arm or bend the elbow.
• If not torn completely, there may only be pain at the front of the shoulder.

Due to the biceps muscle's connection to the shoulder joint, other problems that may occur in conjunction with biceps tendonitis include injuries such as shoulder impingement, shoulder instability, tears in the glenoid labrum that can lead to frozen shoulder, arthritis, and rotator cuff tendon tears.

Causes of Biceps Tendon Injuries

In the majority of cases, wear and tear of the biceps tendon causes damage. This wear and tear is often due to overuse of the shoulder during many overhead activities that we perform in our daily lives, hobbies, and sports. With overuse, tendons can weaken with microtears that cause irritation, eventually leading to inflammation (tendinitis). When tendonitis develops over a long period of time from overuse, it is referred to as chronic tendinitis.

Biceps tendinitis often occurs with other shoulder conditions or injuries, usually with damage to the biceps tendons. A fall on an outstretched hand or a direct blow to the shoulder can cause acute tendonitis (tendinitis that comes on quickly) if the biceps tendon is damaged. If left untreated, both types of tendinitis may develop into tenosynovitis or a complete tear (rupture).

Specific causes of biceps tendonitis, tenosynovitis, and tears in the biceps tendon include:

• Sports that involve repetitive throwing, lifting or forceful contact such as swimming, baseball, tennis, gymnastics, and weightlifting.
• A torn transverse humeral ligament. This ligament usually holds the biceps tendon in the bicipital groove at the top of the humerus, but if torn, the tendon can slip out of the groove and become irritated.
• Work that requires repetitive overhead movements such as painting, hammering, and overhead lifting.
• Straining the biceps muscle or tendon due to overuse or unusual use.
• Having an ongoing or previous shoulder injury that may have not healed properly.
• Infection in the shoulder, sometimes following surgery, although this is a less common cause.

Biceps Tendonitis Treatments

If you have a biceps tendinitis, resting your arm is highly recommended. Avoid activities that cause pain or may have caused the inflammation and begin cold compression treatments as soon as possible.

The trick to healing your biceps tendinitis and getting your arm and shoulder back in the best possible condition you can is getting it to heal with minimal scar tissue - something ultrasound therapy is great at! Even with optimum healing, there is always less elasticity in previously injured biceps tendons. However, if you heal your tendinitis properly and treat scar tissue build up, your chance of re-injury or chronic shoulder conditions later on is much lower than average.

There are healing tools that can help treat your biceps tendonitis and speed up the healing process so you can get back to a life without pain and risk of further injury. Therapeutic Ultrasound and Blood Flow Stimulation Therapy (BFST^®) will treat scar tissue and promote blood flow to heal your tendonitis faster and more completely than any other methods available.

Freezie Wrap^® Cold Compression Therapy

To decrease inflammation and relieve the pain of biceps tendinitis doctor's recommend cold compression therapy. For acute tendinitis, cold compression therapy within the first 48 - 72 hours following the injury and after any further irritation is important to limit the amount of damage done to your tissue. Cold compression therapy will relieve pain and swelling of both chronic and acute tendinitis and will reduce, or even eliminate, the need for NSAIDs.

The Leg/Arm Freezie Wrap^® is the cold compression tool you need to treat your tendon injury that occurs at the top of the biceps tendon. Leg/Arm Freezie Wrap^® will treat biceps tendinitis that is located along the upper arm in an effective and convenient way.

Cold Compression Therapy works by interrupting and slowing nerve and cell function in the injured area and reducing swelling that can block blood vessels. This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood through your tendon and tissue cells begin to break-down. Without cold compression therapy, cellular break-down and tissue damage continues as the cells do not get the oxygen they need to survive. By limiting the amount of damage done to your biceps tendon, you also limit the amount of healing that needs to occur. This is a very important step to get rid of biceps tendinitis faster and with less pain!

The deep cooling effect provided by the Freezie Wrap^® slows cell metabolism thereby reducing cellular break-down and tissue damage. Furthermore, because the cold wraps gently numb the nerves, the wraps also reduce pain!

The Freezie Wrap^® uses a supercharged cooling gel pack, that chills in the fridge, not in the freezer like ice or other freezer packs, giving you deep cold therapy without the risk of 'cold burns' or cryoburn. The medical-grade wrap keeps the cold directly off your skin preventing cryoburn while delivering cold right where you need it.

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Ultrasound Therapy

Ultrasound therapy is a great therapeutic option to decrease inflammation and pain experienced with biceps tendinitis. Therapeutic ultrasonic waves increase tissue elasticity while increasing blood flow to your injured biceps tendon. This cleans the injured area by getting rid of damaged tissue and reducing the inflammation while opening up the blood vessels to begin healing.

Not only does ultrasound aid in the duration of healing, but it helps to prevent long term complications. Pain, lack of mobility, tendinosis, or a complete rupture in the biceps are some of the more common long term complications that can occur when biceps tendinitis goes untreated. By treating your biceps with ultrasound, scar tissue becomes softer and the tendon and other tissue becomes stronger reducing the risk of chronic problems in the future.

In addition, scar tissue can bind the tendon to other tissue within the rotator cuff surrounding the biceps. The inflexible scar tissue limits the movement of these tendons and ligaments that were once elastic and allowed the shoulder its large range of motion. As a result, movement of the entire joint is limited making it difficult to lift your arm or to reach for objects. If left untreated, the shoulder may 'freeze' (a condition called frozen shoulder or adhesive capsulitis) altogether making movement impossible. At the very least, scar tissue leaves your biceps tendon weaker than a healthy tendon, leaving your biceps at greater risk of further deterioration and possible tearing.

Fortunately, you can treat your biceps tendonitis with MendMeShop Ultrasound to soften scar tissue and improve the motion and flexibility of your shoulder.

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.

MendMeShop^® ultrasound therapy with phonophoresis is safe, convenient, and easy and generally requires 10 minutes per treatment. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send micro vibrations into your body and carry medicated molecules within the ultrasound gel deep into your soft tissue to enhance the ultrasound therapy, resulting in even healthier tissue. Ultrasound waves penetrate deep to relax your muscles, decrease inflammation and accelerate your recovery rate, so you can return to your daily activities as soon as possible.

Using MendMeShop Lavender Infusion Ultrasound Gel during your ultrasound therapy gives you 2 therapies in 1. You get the benefit of the regenerating sound waves from the ultrasound device itself AND the added bonus of the therapeutic ingredients inside the gel being delivered into the tissue where it is most effective. 1 FREE bottle of MendMeShop^® Lavender Infusion Ultrasound Gel comes with every MendMeShop^® Ultrasound Therapy System and it contains the therapeutic essential oils of natural Bulgarian lavender, peppermint, eucalyptus, and menthol.

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Once the inflammation of your tendinitis has been reduced, nourishing and strengthening the biceps tendon and surrounding area is recommended. Using Blood Flow Stimulation Therapy will speed your recovery and heal your biceps more completely preparing it for strengthening exercises. Talk to your doctor or physical therapist to find out which exercises are appropriate for your situation.

Inferno Wrap^® Blood Flow Stimulation Therapy

After severe inflammation and swelling is reduced, begin treating your biceps with Blood Flow Stimulation Therapy (BFST^®). BFST^® increases the amount of blood that flows naturally to your arm and shoulder to nourish your soft tissue to speed healing.

The biceps naturally receives a limited blood supply and when you stop moving your shoulder because it hurts the blood flow is reduced even further, limiting your body's natural ability to heal itself.

By treating your biceps tendon with BFST^® you can increase your body's blood supply to the biceps tendon and increase your body's natural healing power.

An Inferno Wrap^® is the tool you need to treat your sore arm and shoulder because it speeds healing and relaxes the surrounding muscles. With BFST^®, tissues are safely and gently stimulated. Your body responds with a rapid increase in blood flow to the biceps, increasing the supply of oxygen and nutrients to injured tissue cells to promote healing. Our Leg/Arm Inferno Wrap^® provides effective, non-invasive, non-addictive pain relief and healing with no side effects.

In addition, the improved blood flow whisks away dead cells and toxins that have built up from your biceps tendinitis. When you stop moving your arm and shoulder due to pain, your muscles and other tissue can become weaker and dead cells and toxins in the area can cause further tissue deterioration - this can lead to atrophy. By clearing the area of toxins and increasing the amount of oxygen and nutrients to your tendon and other tissue, the risk of atrophy (muscle weakness and/or deterioration) is greatly reduced. Keeping your forearm tissue as healthy as possible throughout the healing process will allow you to improve arm strength again once your pain has gone and your tendinitis has healed.

Click here to learn more about how BFST^® and Inferno Wraps^® work.

With these 3 easy therapies, cold compression, ultrasound and BFST^®, you will notice significantly reduced pain and an incredible improvement in your biceps tendon.

Remember: We recommend that you consult your doctor and/or physiotherapist before using any of our outstanding products, to make sure they're right for you and your condition.

During your recovery, you may have to modify and/or eliminate any activities that cause pain or discomfort in your biceps area until your pain and inflammation settle, and you gain more mobility and strength in your shoulder. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!