Tendons attach muscles to bone and are composed of strong connective tissue. Tendinitis of the biceps brachii is a condition where the tendons situated at the shoulder or elbow become inflamed, swollen and painful. Caused primarily by overuse of the muscle-tendon structure, tendinitis can also lead to tendinosis, or microtears of the tendon sheath, according to the Langone Medical Center.
Anatomy
The biceps brachii muscle is located on the front of the upper arm. At the elbow, the biceps tendon attaches onto the radius, one of the bones of the forearm. At the shoulder, the biceps muscle has two tendons that attach onto the scapula, or shoulder blade. It is responsible for flexing the elbow, or moving the forearm closer to the upper arm; supinating the wrist, or flipping the palm of the hand to face up; and flexing the shoulder forward, to reach up in front of the body.
Cause
Tendinitis of the biceps tendons can occur in response to other disease processes such as diabetes or arthritis, but it typically appears in response to an overuse injury. Activities that place repetitive strain on the biceps tendon include tennis, pitching, painting, overhead assembly work, weigh lifting, climbing and cleaning. Any activity that repetitively flexes the elbow or positions the arms overhead long-term can cause tendinitis of the biceps tendons, according to Cedars-Sinai Hospital.
Signs and Symptoms
Signs and symptoms of biceps tendinitis at the elbow include pain when the elbow is flexed, or bent; pain when the tendon is lightly pressed with a finger at approximately one inch below the front of the elbow, where the tendon attaches onto the radius; and pain when the biceps is stretched. Tendinitis of the biceps tendons at the shoulder will give pain when the arm is raised overhead, tenderness at the front of the shoulder and a clicking sound when the arm is moved overhead, reports Cedars-Sinai Hospital.
Treatment
Initial treatment begins by avoiding the activities that cause pain in the inflamed area and application of the R.I.C.E principle: rest, ice, compression and elevation. Apply ice to the affected region for 20 minutes, using a cloth; allow the skin to return to normal temperature, and then reapply, using light compression and elevation to help reduce inflammation. Use over-the-counter anti-inflammatory medication to reduce pain and swelling. Once the pain has subsided, stretch the biceps muscle regularly and return to light activity, avoiding pain in the process. Apply heat to soothe the tendon once pain has subsided. Never use heat on an acute injury. If the injury persists, limiting activities of daily living, surgery may be an option to reduce pain and inflammation, according to the Langone Medical Center.
Prevention
To prevent tendinitis, regularly stretch the tendons by positioning the arm straight in back of the body while grasping the frame of a door, notes Cornell University Fitness Centers. Strengthen the biceps muscle using light weight at first; avoid overusing the tendons; change positions regularly during exercise and at work to avoid overuse and avoid pain.
