Biceps Tendon

In its entirety, the biceps muscle, as the name suggests, has two sinewy origins. A distinction is made between the short and long biceps tendon or the caput breve and caput longum. The origin of the long tendon begins at the upper glenoid rim of the shoulder joint and the “cartilage lip” (tuberculum supraglenoidale) located there.

The short tendon of the Musculus biceps brachii originates from the Processus coracoideus, a bony process of the shoulder blade, which is also called the coracoid process. The long biceps tendon runs along the humerus through a kind of bony channel, the so-called sulcus intertubercularis, and has its starting point at the bony roughening of the radius of the radius. This tendon runs not only over the entire head of the humerus, but also intracapsularly, i.e. it has a tendon-sheath-like sheath that promotes the mechanism of sliding.

Tear / Injury of the biceps tendon

Ruptures of the biceps tendon, i.e. a tear of the tendon, are distinguished on the basis of their location. With a proximal rupture, a tear of the tendon further towards the middle of the body, the long biceps tendon is usually affected. This is often caused by a sudden and intensive exertion of force when the tendon is pre-damaged.

This injury is the most common. Another proximal injury is the so-called SLAP lesion. The SLAP lesion is a tear in the long biceps tendon directly at its anchorage on the acetabular roof.

A SLAP lesion is often very difficult to diagnose (even on MRI of the shoulder) and often difficult to treat. In the case of a distal rupture, i.e. a tear of the tendon further from the centre of the body, the cause is usually a severe trauma. Acute ruptures of the biceps tendon, triggered by a maximum load or a fall, are often accompanied by symptoms such as painfulness, restricted movement and loss of strength (especially during flexion and rotation).

A severe swelling above the elbow is usually caused by ruptures of the long biceps tendon. Distal ruptures have their muscle belly on the proximal upper arm, where it is also clearly visible. This can be easily visualized by ultrasound (sonography).

A clear diagnosis is often difficult. For the examining physician, a thorough clinical examination must be carried out. The supination test with close observation of the biceps muscle serves as an important criterion for making a diagnosis. The diagnosis is supported by the preparation of an MRT. A subsequent imaging procedure using X-rays is used to rule out bony outbreaks.

Inflammation of the biceps tendon (tendinitis)

The inflammation of the long biceps tendon (caput longum) is an acute and painful inflammation. It mostly affects athletes, e.g. in swimming, tennis or handball, where the tendon is subjected to heavy or excessive strain over a long period of time. Trauma caused by an accident, for example, is rarely considered as a cause.

Pain is often located in the area of the front shoulder, which can radiate further to the elbow. Pain is usually particularly severe when the tendon is stretched and put under pressure. Swelling in the shoulder area is less frequently noticed.

In this inflammatory process, mineral deposits not only cause pain but also further damage to the tendon. Physiotherapeutic treatment is the method of choice for therapy. This should be combined with a break from physical activities or efforts in order to aggravate the inflammation or even injury. The last resort in therapy should be surgical intervention.