Symptoms
In the presence of an inflammation of the biceps tendon, the typical signs of inflammation can usually be observed. The affected patients usually feel dull and/or stabbing pain in the front of the shoulder at a very early stage. These pains often radiate into the neck and upper arm.
In addition, a direct comparison of the sides of both arms shows that the shoulder affected by the inflammatory processes is clearly overheated. Due to the relatively deep course of the biceps tendons, swelling and redness only occur in particularly pronounced cases of illness. People who suffer from biceps tendon inflammation can usually only move the affected arm to a limited extent or not at all. Occasionally, when trying to lift the affected arm sideways, a snapping, jumping or cracking sound can be heard.
Diagnosis
The diagnosis of biceps tendon inflammation comprises several steps. At the beginning, there is usually a comprehensive doctor-patient consultation (anamnesis), during which the affected patient should describe the existing symptoms as detailed as possible. Already the complaints felt by the patient provide a first indication of the presence of a biceps tendon inflammation.
This is followed by an orienting physical examination comparing the sides of the biceps tendon. If the presence of biceps tendon inflammation is suspected, the doctor will begin with an inspection of the shoulders and arms. He pays particular attention to deformities, skin symptoms (for example redness), wounds and scars.
The actual examination then begins. There is a variety of special examinations that can help to diagnose pathological changes in the area of the long biceps tendon. Due to the causative diseases, a patient suffering from an inflammation of the biceps tendon usually shows a significant restriction of movement in the shoulder joint.
In addition, imaging techniques in particular play a decisive role in the diagnosis of biceps tendon inflammation. With the help of an ultrasound examination (sonography), thickenings and fluid accumulations in the area of the long biceps tendon can be depicted. In addition, magnetic resonance imaging of the shoulder (MRI) of the affected shoulder can help diagnose biceps tendon inflammation. In addition to the quality and inflammation of the biceps tendon, an MRI of the shoulder can also reveal damage to the rotator cuff, cartilage damage in the shoulder joint and other pathological processes.
Duration of biceps tendon inflammation
Biceps tendon inflammations can be of very different durations. If you feel pain on your shoulders after a strenuous workout or other special strain, this pain can be quickly relieved with cold applications and immobilization and the inflammation can be nipped in the bud. If the inflammation has (un-)noticed already advanced, it can last for weeks or months and, depending on the treatment/immobilization, it can always cause new problems.
A complete immobilization of the shoulder region is very difficult in everyday life and a too early return to sports activities can lead to a renewed occurrence of the inflammation. If an operative therapy takes place, a stress-free period of at least 2 weeks must be assumed after the operation and full weight-bearing of the shoulder only after 8-12 weeks. The treatment of biceps tendon inflammation depends primarily on the underlying cause.
Acute complaints caused by the inflammatory processes in the area of the muscle tendon can be alleviated by taking pain-relieving medication. Painkillers (analgesics) containing the active ingredients paracetamol or ibuprofen are particularly suitable for relieving the symptoms of biceps tendon inflammation. Since the active ingredient ibuprofen has both pain-relieving and anti-inflammatory properties, its use should be preferred.
In addition, local cold applications can help to relieve the acute symptoms of biceps tendon inflammation. Patients who suffer from particularly pronounced symptoms can treat the affected shoulder with the help of a cooling pad or cooling cushion. In this context, however, care must be taken to ensure that the coolant is never applied directly to the skin surface.
Otherwise the skin and the tissue immediately below the skin surface may be damaged by the cold. The use of heat plasters is strongly discouraged in the presence of biceps tendon inflammation. Heat usually causes the inflammatory processes to spread further and the symptoms felt by the patient to become more intense.
Further treatment of the biceps tendon inflammation is usually carried out over a period of three to six months with various elements. Above all, regular participation in physiotherapy exercises plays a decisive role in the treatment of biceps tendon inflammation. In addition, the injection of local anaesthetics and cortisone preparations near the affected biceps tendon can help to accelerate the healing process.
Local massages of the shoulder region and upper arm are also typical treatment measures for patients suffering from biceps tendon inflammation. In addition, the therapy of biceps tendon inflammation can be carried out for a variety of the causative diseases by the local application of ultrasound waves or stimulation currents. In the case of an inflammation of the biceps tendon which has developed in the course of the impingement syndrome, in many cases a surgical correction of the shoulder joint must be carried out.
Patients suffering from biceps tendon inflammation should make sure that they do not put any weight on the affected arm for a while. Sports activities should generally be discontinued until the inflammatory processes have healed completely. Otherwise, serious complications may arise, which may require surgical removal of the tendon.
There are various physiotherapeutic treatment options for inflammation of the biceps tendon. One of these is conservative therapy through physiotherapy. The aim of therapy is to restore the full range of motion and freedom from pain in the shoulder joint.
Physiotherapeutic treatment includes, among other things, gymnastics for the shoulder muscles. The patient should be introduced to exercises that serve to build up muscles in the shoulder area. In the long term, these exercises should be carried out regularly on the patient’s own initiative in order to enable muscle growth in the shoulder girdle.
The muscles of the rotator cuff play an important role in this process, as they guide the shoulder blade and can only contribute to relieving the bipipedal tendon if they function properly. The triceps is also important at this point. The mobilisation of the corresponding muscles can be carried out passively by the therapist, actively by the patient or by a mixture of both.
If it is an inflammation of the tendon caused by overstrain, the main focus during physiotherapeutic treatment is on relieving the shoulder joint, accompanied by a break from physical activity. There are currently various Voltaren® products on the market, which differ in the way they are applied and the dosage. They all have the active ingredient diclofenac in common, which is an anti-inflammatory (antiphlogistic) substance that primarily relieves pain and inhibits inflammation.
In biceps tendon inflammation, therefore, the application of a Voltaren® ointment is very helpful in relieving the local inflammatory symptoms such as redness, swelling and overheating, but also pain. Depending on the intensity of the symptoms and the product properties, the ointment should be applied to the affected area in the area of the long biceps tendon. The Voltaren Ointment® should be generously distributed over the respective shoulder joint, as this is where the tendonous parts of the muscle are located, which cause the symptoms in the event of inflammation.
The muscle pulls along the upper arm up to its base at the ulna. If necessary, the ointment can also be rubbed into the muscular parts of the muscle here, due to the pain radiating from the sinewy parts. The exact dosage and application should be taken from the respective package insert.
In principle, the ointment can be applied several times a day. After an inflammation of the biceps tendon, physiotherapeutic treatment in addition to the application of pain and anti-inflammatory ointments is indispensable to achieve full functionality and regeneration of the injured tendon. A common therapeutic application is the so-called transverse friction.
This is intended to reduce pain while at the same time increasing mobility. The friction, i.e. rubbing, should be transverse to the longitudinal course of the tendon. In the case of biceps tendon inflammation, the tendonous part is preferably massaged with the help of the fingers without the person affected feeling pain.
This is intended to promote local blood circulation. In other indications, this method can be used to relieve tension or hardening. It is important to know that cross friction may only be used in the event of inflammation of the biceps tendon.
Calcification of the biceps tendon in the approach is considered a contraindication. The treatment of an inflammation of the biceps tendon provides for special stretching exercises in addition to drug therapy, pain-relieving therapy as part of physiotherapy and prior protection of the affected biceps tendon. The stretching of the biceps tendon inflammation should, however, only take place when the acute symptoms in the form of pain, redness and overheating have subsided.
In the following, three exercises will be explained as examples of stretching the biceps tendon after an inflammatory disease. The stretching exercises should all be held for about 20-30 seconds and repeated several times if necessary. It is important to mention that stretching exercises are generally more suitable for the muscular part of muscles and not for the sinewy part.
Nevertheless, the stretching exercises have a positive effect on the therapy of biceps tendon inflammation. – For a first exercise, stand with the side of the affected shoulder against the wall or a door frame. The affected arm is stretched backwards parallel to the floor and pressed lightly against the wall or door frame until a feeling of stretching occurs.
- The arm of the affected side is stretched forward and parallel to the floor, with the palms of the hands facing upwards, so that the palm of the other hand can be pressed slightly towards the floor. – Both arms are brought together behind the back and the hands are placed inside each other so that the palms of the hands are facing down. Now the arms are stretched away from the body towards the ceiling until a stretch is felt in the biceps.
Swimming is one of the sports where injuries such as biceps tendonitis can occur. The biceps has its origin with the long and short biceps tendon in the area of the shoulder joint, so an inflammation of the biceps tendon is closely related to inflammation in the shoulder joint. When swimming, the shoulder joint is actively strained, so that overloading or incorrect loading can lead to inflammation of the biceps tendon.
Although swimming can be a trigger for the biceps tendon inflammation, swimming can possibly also serve as a low-stress sports activity to maintain mobility in the shoulder joint. The biceps is involved in the movement of the body during swimming, but the load in this case is not comparable to lifting weights to build up the muscles of the biceps. In addition, no forced flexing position in the elbow joint is assumed during swimming, which in turn suggests that after an inflammation of the biceps tendon, a slow habituation to movements in the form of swimming should be aimed for. In general, it is at the individual discretion of the person affected whether the intensity of pain allows moderate swimming or not. However, it is important not to immobilize the joint, but to spare the origin of the biceps tendon in the shoulder joint.
