Test

In order to diagnose biceps tendon inflammation, functional tests play a major clinical role. However, palpation always comes first – the doctor palpates the long biceps tendon in its course and tests whether the application of pressure causes pain. This would be a first indication of inflammation.

In addition, the doctor also tests whether there are any restrictions on movement or whether pain occurs during certain movements. In the next step, the muscle strength is tested in a side comparison and evaluated in a 5-step system. Then the doctor performs the so-called palm-up test, a functional test of the long biceps tendon.

For this test, the patient sits upright on a treatment couch. The affected arm is spread out horizontally at a 90° angle; the elbow is stretched to the maximum. The palm of the patient’s hand points upwards.

Now the shoulder is brought into 30° horizontal flexion. The doctor then exerts a ground-directed pressure on the wrist and the patient should hold against it. If pain develops or the patient is unable to counteract the pressure, this is a further indication of biceps tendon inflammation. However, other clinical pictures could also be present, such as subluxation (incomplete dislocation) of the biceps tendon or subacromial impingement syndrome (bottleneck syndrome on the shoulder).

Duration

An inflammation of the biceps tendon is first of all a protective reaction of the body to protect against further (over)strain, injury or infection. If suitable measures are taken early on, such as immobilization, the inflammation usually heals on its own within a few days. Often, however, adequate immobilization of the biceps tendon is hardly possible in everyday life, so that the tendon cannot heal completely.

Then it takes weeks to months until the biceps tendon inflammation subsides again. If the biceps tendon is stressed again too early, e.g. through sport, the inflammation is rekindled again and again. In addition, there is a risk that the substance of the biceps tendon will be affected, resulting in biceps tendon tears. These must then be treated surgically, so that the duration is extended by further weeks or months.