Biceps tendon endinitis

An inflammation of the long biceps tendon is also called biceps tendon endinitis. Such inflammation often occurs in people with postural deformities with shoulders hanging forward and causes severe shoulder pain. The long biceps tendon lies in a narrow bony canal in the shoulder joint and is susceptible to overloading and injury because it is often subject to friction in its narrow course.

The constant irritation can cause the tendon to swell and become inflamed. As it progresses, in some cases the biceps tendon is further damaged in the form of fraying and the tendon becomes unstable. Biceps tendon endinitis can also be caused by a muscular imbalance of the rotator cuff of the shoulder.

This is called a thoracic spine malposition, in which the support muscles at the back of the rotator cuff are too weak. The dominant chest muscles pull the shoulders forward, causing shoulders to hang forward and the narrow channel through which the biceps tendon runs to contract further. The diagnosis of a biceps tendon tendinitis is made with the so-called test according to Yergason, in which the arm rests against the body with the elbow bent at right angles and now an attempt is made to lift the forearm against the resistance of the doctor.

In the process, pain is provoked in the area of the front shoulder in the case of biceps tendon dinits. In order to treat muscular imbalance and to achieve relief in the area of the irritated and inflamed biceps tendon in biceps tendon endinitis, targeted muscle training under physiotherapeutic guidance to strengthen the posterior rotator cuff must be performed. In most cases, this can bypass surgical cutting of the biceps tendon.

Synonyms:Omarthrosis, Glenohumeralarthrosis
Location of the greatest pain: In the shoulder joint, sometimes with pain radiating into the upper arm.
PathologyCause:There are many causes of shoulder arthrosis. In addition to wear and tear of the joint (arthrosis), accidents with bone fractures or inflammatory diseases (for example rheumatoid arthritis) can lead to shoulder arthrosis.
Age:Usually higher or advanced age.
Gender:Women somewhat more often.
Accident:mostly due to wear and tear
Pain type:Dull pain, which increases with strain, but also pain at rest and at night.
Pain development:Progressive arthrosis leads to an incompetition (unevenness) of the joint surfaces. Cartilage cells die and are broken down in an inflammatory process.
This inflammatory process causes pain.
Pain occurrence:Motion-dependent, but also pain at rest and at night.
External aspects:In the early stages inconspicuous, later bony growths (osteophytes) and weakening of the shoulder cap muscles.

Severe shoulder pain can also be caused by shoulder arthrosis (omarthrosis). In this case, the abrasion of cartilage in the head of humerus and/or the glenoid cavity leads to joint wear in the shoulder joint. Shoulder arthrosis is divided into a primary (no apparent cause, age-related wear and tear of the joint) and a secondary (after bone fractures or as a result of necrosis of the head of humerus).

A deformation of the humerus can be seen on the X-ray image. In addition, the reduction of the articular cartilage is visible as a narrowing of the visible joint space. Shoulder arthrosis often results in restricted mobility.

In addition, it causes movement-dependent pain in the shoulder joint and, in many cases, intermittent inflammatory activation of the joint.Shoulder arthrosis is treated with medication, physical therapy, cooling or surgical measures (e.g. arthroscopy, prosthesis, artificial shoulder joint).

Synonyms:Condition after dislocation of the shoulder joint or dislocation of the shoulder, damage to the anterior glenoid rim.
Location of the greatest pain: In most cases, the shoulder joint bulges out forward and downward. This can lead to bony or cartilaginous damage to the anterior glenoid rim of the shoulder joint.
Pain is therefore most often located at the front edge of the glenoid cavity, especially during throwing movements. This is especially true if a shoulder dislocation after self-reposition (re-injection by the patient or by himself) has not been diagnosed by a physician.
Cause of Pathology: Shoulder dislocation with accidental tearing of the acetabular rim.
Age:Frequently younger patients who are active in sports and have a hyperlaxed ligamentous apparatus.
Gender:no gender preference
Accident:In 90% of all cases, a dislocation of the shoulder in a downward direction (subcoracoidal dislocation) occurs. In this case the lower front edge of the socket tears off.
Type of pain: stabbing, bright.
Partial feeling of instability of the joint.
Origin of pain:Instability after damage.
Pain:Instability due to mobility in the direction of the missing edge of the socket and, secondarily, due to incipient wear and tear of the joint.
External aspects:In case of instability, migrationMobility of the humeral head (humerus head) is possible.

A bench type lesion is usually caused by a dislocation of the shoulder (dislocation) forward as a result of an accident. A Bankart lesion is a condition in which the so-called glenoid labrum of the glenoid cavity of the shoulder blade is partially or completely torn off. This joint lip actually stabilizes the glenoid joint in the socket and further dislocation of the shoulder can easily occur.

Often the bench type lesion is accompanied by a feeling of instability in the glenohumeral joint. From a Bankart lesion with shoulder pain are usually younger and athletically active people with an overmobile ligamentous apparatus.

Synonyms:Shoulder joint arthrosis, acromioclavicular joint arthrosis
Location of the greatest pain: The greatest pain is located directly above the AC joint.
Cause of pathology:The cause of ACG arthrosis is unclear.
It is caused by injuries to the joint such as acromioclavicular joint dislocation (ACG dislocation) or collarbone fracture.
Age:Usually in the context of wear and tear increasing with age.
Gender:Men > Women
Accident:see cause
Pain type:dull
Pain development: slowly increasing
Pain occurrence:load dependent
External aspects:With increasing wear and tear of the joint, there are bony attachments that can be palpated externally.

The acromioclavicular joint (acromioclavicular joint, AC joint, ACG) is the articulated connection between the upper end of the shoulder blade, the so-called shoulder height (acromion), and the outer end of the clavicle. If wear and tear (arthrosis) occurs in this area, this usually results in a painful restriction of shoulder movement. The treatment of such ACG arthrosis is usually based on the individual complaints.

In most cases, therapy with physiotherapy and physical applications (e.g. cold, electrotherapy) is attempted. If the shoulder pain is not sufficiently relieved and the movement restriction cannot be lifted, a resection of the AC joint can be considered. For this purpose, the joint surfaces are milled off and a kind of meniscus made of the body’s own material is placed between the joint surfaces. After such an operation, the shoulder can often be fully loaded again after only two months and is painless.