Long head of the biceps tendon pain: differential diagnosis and treatment

Journal of Orthopaedic and Sports Physical Therapy

Volumn 39, Issue 2, 2009, Pages 55-70

  Krupp, Ryan J ^a   Kevern, Mark A ^b   Gaines, Michael D ^a   Kotara, Stanley ^c   Singleton, Steven B ^c  

^a Steadman Hawkins Clinic of the Carolinas   (United States)

^b Proaxis Therapy   (United States)

^c NONE   (United States)

Author keywords

Impingement; Rotator cuff; Shoulder; Tendinitis; Tendinosis

Indexed keywords

DIFFERENTIAL DIAGNOSIS; HUMAN; METHODOLOGY; MUSCLE DISEASE; ORTHOPEDIC SURGERY; REVIEW; SHOULDER PAIN; TENDON;

DIAGNOSIS, DIFFERENTIAL; HUMANS; MUSCULAR DISEASES; ORTHOPEDIC PROCEDURES; SHOULDER PAIN; TENDONS;

EID: 64249138850     PISSN: 01906011     EISSN: None     Source Type: Journal    
DOI: 10.2519/jospt.2009.2802     Document Type: Review

References (83)

1. Ahrens PM, Boileau R The long head of biceps and associated tendinopathy. J Bone Joint Surg Br. 2007;89:1001-1009. http://dx.doi. org/10.1302/0301-620X.89B8.19278
2. Alpantaki K, McLaughlin D, Karagogeos D, Hadjipavlou A, Kontakis G. Sympathetic and sensory neural elements in the tendon of the long head of the biceps. J Bone Joint Surg Am. 2005;87:1580-1583. http://dx.doi.org/10. 2106/ JBJS.D.02840
3. Altchek D, Wolf B. Disorders of the biceps tendon. In: Krishnan S, Hawkins R, Warren R, eds. The Shoulder and the Overhead Athlete. Philadelphia, PA: Lippincott, Williams & Wilkins; 2004:196-208.
4. Andrews JR, Carson WG, Jr., McLeod WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985;13:337-341.
5. Barber FA, Byrd JW, Wolf EM, Burkhart SS. How would you treat the partially torn biceps tendon? Arthroscopy. 2001;17:636-639. http://dx.doi. org/10.1053/jars.2001.24852
6. Barber FA, Field LD, Ryu R. Biceps tendon and superior labrum injuries: decision-marking. J Bone Joint Surg Am. 2007;89:1844-1855.
7. Becker DA, Cofield RH. Tenodesis of the long head of the biceps brachii for chronic bicipital tendinitis. Long-term results. J Bone Joint Surg Am. 1989;71:376-381.
8. Bell RH, Noble JS. Biceps disorders. In: Hawkins R, Misamore GW, eds. Shoulder Injuries in the Athlete: Surgical Repair and Rehabilitation. New York, NY: Churchill Livingston; 1996:267-282.
9. Berlemann U, Bayley I. Tenodesis of the long head of biceps brachii in the painful shoulder: improving results in the long term. J Shou/der Elbow Surg. 1995;4:429-435.
10. Boileau P, Baque F, Valerio L, Ahrens P, Chui- nard C, Trojani C. Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. J Bone Joint Surg Am. 2007;89:747-757. http://dx.doi.Org/10.2106/JBJS.E.01097
11. Boileau P, Krishnan SG, Coste JS, Walch G. Arthroscopic biceps tenodesis: a new technique using bioabsorbable interference screw fixation. Arthroscopy. 2002;18:1002-1012.
12. Burkhart SS, Morgan CD. The peel-back mechanism: its role in producing and extending posterior type II SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy. 1998;14:637-640.
13. Burkhead WZ, Arcand MA, Zeman C, Haber- meyer P, Walch G. The biceps tendon. In: Rock- wood CA, Matsen FA, Wirth MA, Lippitt SB, eds. The Shou/der Vol. 2. Philadelphia, PA: Saunders; 2004:1059-1119.
14. Claessens H, Snoeck H. Tendinitis of the long head of the biceps brachii. Acta Orthop Belg. 1972;58:124-128.
15. Clark JM, Harryman DT, 2nd. Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic anatomy. J Bone Joint Surg Am. 1992;74:713-725.
16. Cone RO, Danzig L, Resnick D, Goldman AB. The bicipital groove: radiographic, anatomic, and pathologic study. A JR Am J Roentgenol. 1983;141:781-788.
17. Connell DA, Potter HG, Wickiewicz TL, Altchek DW, Warren RF. Noncontrast magnetic resonance imaging of superior labral lesions: 102 cases confirmed at arthroscopic surgery. Am J Sports Med. 1999;27:208-213.
18. Cook C, Hegedus E. Physical exam tests for the shoulder. In: Cook C, Hegedus E, eds. Orthopedic Physical Examination Tests: An Evidence Based Approach. New Jersey: Pearson Prentice Hall; 2008:98-99.
19. Cools AM, Witvrouw EE, De Clercq GA, et al. Scapular muscle recruitment pattern: electromyographic response of the trapezius muscle to sudden shoulder movement before and after a fatiguing exercise. J Orthop Sports Phys Ther. 2002;32:221-229.
20. Cools AM, Witvrouw EE, Declercq GA, Vander- straeten GG, Cambier DC. Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms. Br J Sports Med. 2004;38:64-68.
21. Crenshaw AH, Kilgore WE. Surgical treatment of bicipital tenosynovitis. J Bone Joint Surg Am. 1966;48:1496-1502.
22. Dines D, Warren RF, Inglis AE. Surgical treatment of lesions of the long head of the biceps. Clin Orthop Relat Res. 1982:165-171.
23. Eakin CL, Faber KJ, Hawkins RJ, Hovis WD. Biceps tendon disorders in athletes. J Am Acad Orthop Surg. 1999;7:300-310.
24. Edwards TB, Walch G. Open biceps tenodesis: the interference screw technique. Tech Shoulder Elbow Surg. 2003;4:195-198.
25. Ford LT, DeBender J. Tendon rupture after local steroid injection. South Med J. 1979;72:827-830.
26. Froimson Al, 0 I. Keyhold tenodesis of biceps origin at the shoulder. Clin Orthop Relat Res. 1975:245-249.
27. Fu FH, Harner CD, Klein AH. Shoulder impingement syndrome. A critical review. Clin Orthop Relat Res. 1991;162-173.
28. Gartsman GM, Hammerman SM. Arthroscopic biceps tenodesis: operative technique. Arthroscopy. 2000;16:550-552. http://dx.doi. org/10,1053/jars.2000. 4386
29. Gilcreest EL. Two cases of spontaneous rupture of the long head of the biceps flexor cubiti. Surg Clin N Am. 1926;6:539-554.
30. Gill TJ, Mclrvin E, MairSD, Hawkins RJ. Results of biceps tenotomy for treatment of pathology of the long head of the biceps brachii. J Shoulder Elbow Surg. 2001;10:247-249. http://dx.doi. org/10.1067Anse.2001.114259
31. Glousman RE. Instability versus impingement syndrome in the throwing athlete. Orthop Clin North Am. 1993;24:89-99.
32. Graichen H, Hinterwimmer S, von Eisenhart-Rothe R, Vogl T, Englmeier KH, Eckstein E Effect of abducting and adducting muscle activity on glenohumeral translation, scapular kinematics and subacromial space width in vivo. JBiomech. 2005;38:755-760. http://dx.doi. org/10.1016/j.jbiomech.2004.05.020
33. Green S, Buchbinder R, Hetrick S. Physiotherapy interventions for shoulder pain. Cochrane Database Sysf Rev. 2003;CD004258. http://dx.doi. org/10.1002/14651858.CD004258
34. Habermeyer R Magosch P, Pritsch M, Scheibel MT, Lichtenberg S. Anterosuperior impingement of the shoulder as a result of pulley lesions:a prospective arthroscopic study. J Shoulder Elbow Surg. 2004;13:5-12. http://dx.doi. org/10.1016/S1058274603002568
35. Harryman DT, 2nd, Sidles JA, Clark JM, Mc- Quade KJ, Gibb TD, Matsen FA, 3rd. Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am. 1990;72:1334-1343.
36. Harryman DT, 2nd, Sidles JA, Harris SL, Matsen FA, 3rd. The role of the rotator interval capsule in passive motion and stability of the shoulder. J Bone Joint Surg Am. 1992;74:53-66.
37. Jobe FW, Bradley JP. The diagnosis and nonoperative treatment of shoulder injuries in athletes. Clin Sports Med. 1989;8:419-438.
38. Kelly AM, Drakos MC, Fealy S, Taylor SA, O'Brien SJ. Arthroscopic release of the long head of the biceps tendon: functional outcome and clinical results. Am J Sports Med. 2005;33:208-213.
39. Kennedy JC, Willis RB. The effects of local steroid injections on tendons: a biomechanical and microscopic correlative study. Am J Sports Med. 1976;4:11-21.
40. Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11:142-151.
41. Kido T, Itoi E, Konno N, Sano A, Urayama M, Sato K. The depressor function of biceps on the head of the humerus in shoulders with tears of the rotator cuff. J Bone Joint Surg Br. 2000;82:416-419.
42. Kim SH, Ha Kl, Kim HS, Kim SW. Electromyographic activity of the biceps brachii muscle in shoulders with anterior instability. Arthroscopy. 2001;17:864-868.
43. Kim SH, Yoo JC. Arthroscopic biceps tenodesis using interference screw: end-tunnel technique. Arthroscopy. 2005:21:1405. http://dx.doi. org/10.1016/j.arthro.2005.08.019
44. Klepps S, Hazrati Y, Flatow E. Arthroscopic biceps tenodesis. Arthroscopy. 2002;18:1040-1045.
45. Kumar VP, Satku K, Balasubramaniam P. The role of the long head of biceps brachii in the stabilization of the head of the humerus. Clin Orthop Relat Res. 1989:172-175.
46. Levy AS, Kelly BT, Lintner SA, Osbahr DC, Speer KP, Function of the long head of the biceps at the shoulder: electromyographic analysis. J Shoulder Elbow Surg. 2001;10:250-255. http:// dx.doi.org/10.1067/mse.2001.113087
47. Lo IK, Burkhart SS. Arthroscopic biceps tenodesis using a bioabsorbable interference screw. Arthroscopy. 2004;20:85-95. http://dx.doi. org/10.1016/j.arthro.2003.11.017
48. Ludewig PM, Cook TM. Translations of the humerus in persons with shoulder impingement symptoms. J Orthop Sports Phys Ther. 2002;32:248-259.
49. Lukasiewicz AC, McClure P, Michener L, Pratt N, Sennett B. Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement. J Orthop Sports Phys Ther. 1999;29:574-583.
50. Mariani EM, Cofield RH, Askew LJ, Li GP, Chao EY. Rupture of the tendon of the long head of the biceps brachii. Surgical versus nonsurgical treatment. Clin Orthop Relat Res. 1988:233-239.
51. Mazzocca AD, Rios CG, Romeo AA, Arciero RA. Subpectoral biceps tenodesis with interference screw fixation. Arthroscopy. 2005:21:896. http://dx.doi.Org/10.1016/j.arthro.2005.04.002
52. Murthi AM, Vosburgh CL, NeviaserTJ. The incidence of pathologic changes of the long head of the biceps tendon. J Shoulder Elbow Surg. 2000;9:382-385. http://tlx.doi.org/10.1067/tnse.2000.108386
53. Neer CS, 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54:41-50.
54. Neviaser RJ. Lesions of the biceps and tendinitis of the shoulder. Orthop Clin North Am. 1980;11:343-348.
55. O'Brien SJ, Pagnani MJ, Fealy S, McGlynn SR, Wilson JB. The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J Sports Med. 1998;26:610-613.
56. O'Donoghue DH. Subluxing biceps tendon in the athlete. Clin Orthop Relat Res. 1982;26-29.
57. Osbahr DC, Diamond AB, Speer KR The cosmetic appearance of the biceps muscle after longhead tenotomy versus tenodesis. Arthroscopy. 2002;18:483-487. http://dx.doi.org/10.1053/ jars.2002.32233
58. Pagnani MJ, DengXH, Warren RF, Torzilli PA, Altchek DW. Effect of lesions of the superior portion of the glenoid labrum on glenohumeral translation. J Bone Joint Surg Am. 1995;77:1003-1010.
59. Pagnani MJ, Deng XH, Warren RE Torzilli PA, O'Brien SJ. Role of the long head of the biceps brachii in glenohumeral stability: a biomechanical study in cadavera. J Shoulder Elbow Surg. 1996;5:255-262.
60. Petersson CJ. Degeneration of the glenohumeral joint. An anatomical study. Acta Orthop Scand. 1983;54:277-283.
61. Petersson CJ. Spontaneous medial dislocation of the tendon of the long biceps brachii. An anatomic study of prevalence and pathomechanics, Clin Orthop Relat Res. 1986:224-227.
62. Read JW, Perko M. Shoulder ultrasound: diagnostic accuracy for impingement syndrome, rotator cuff tear, and biceps tendon pathology. J Shoulder Elbow Surg. 1998;7:264-271.
63. Rodosky MW, Harner CD, Fu FH. The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med. 1994;22:121-130.
64. Romeo AA, Mazzocca AD, Tauro JC. Arthroscopic biceps tenodesis. Arthroscopy. 2004;20:206-213. http://dx.doi.Org/10.1016/j.arthro.2003.11.033
65. Sethi N, Wright R, Yamaguchi K. Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg. 1999;8:644-654.
66. Shank JR, Kissenberth MJ, Ramapa A, et al. A comparison of supination and elbow flexion strength in patients with either proximal biceps release or biceps tenodesis. Arthroscopy. 2006;22:e21 (online only). Available at: http://www.arthroscopyjournal.org/issues
67. Sharma P, Maffulli N. Biology of tendon injury: healing, modeling and remodeling. J Musculosk- elet Neuronal Interact. 2006;6:181-190.
68. Smith J, Dahm DL, Kaufman KR, et al. Electromyographic activity in the immobilized shoulder girdle musculature during scapulothoracic exercises. Arch Phys Med Rehabil. 2006;87:923-927. http://dx.doi.Org/10.1016/j.apmr.2006. 03.013
69. Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ. SLAP lesions of the shoulder. Arthroscopy. 1990;6:274-279.
70. Stahl S, Kaufman T. The efficacy of an injection of steroids for medial epicondylitis. A prospective study of sixty elbows. J Bone Joint Surg Am. 1997;79:1648-1652.
71. Swanik KA, Lephart SM, Swanik CB, Lephart SP, Stone DA, Fu FH. The effects of shoulder plyo- metric training on proprioception and selected muscle performance characteristics. J Shoulder Elbow Surg. 2002;11:579-586. http://dx.doi. org/10.1067/tnse.2002.127303
72. Toshiaki A, Itoi E, Minagawa H, et al. Cross- sectional area of the tendon and the muscle of the biceps brachii in shoulders with rotator cuff tears: a study of 14 cadaveric shoulders. Acta Orthop. 2005;76:509-512. http://dx.doi. org/10.1080/17453670510041493
73. Vangsness CT, Jr., Jorgenson SS, Watson T, Johnson DL. The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders. J Bone Joint Surg Br. 1994;76:951-954.
74. Verma NN, Drakos M, O'Brien SJ. Arthroscopic transfer of the long head biceps to the conjoint tendon. Arthroscopy. 2005:21:764. http://dx.doi. org/10.1016/j.arthro.2005.03.032
75. Walch G, Edwards TB, Boulahia A, Nove-Josserand L, Neyton L, Szabo I. Arthroscopic tenotomy of the long head of the biceps in the treatment of rotator cuff tears: clinical and radiographic results of 307 cases. J Shoulder Elbow Surg. 2005;14:238-246. http://dx.doi.Org/10.1016/j.jse.2004.07.008
76. Walch G, Madonia G, Pozzi I, Riand N, Levigne C. Arthroscopic tenotomy of the long head of the biceps in rotator cuff ruptures. In: Gazielly DF, Gleyze P, Thomas T, eds. The Cuff. Paris: Elsevier; 1997:350-355.
77. Wang JH, losifidis Ml, Fu FH. Biomechanical basis for tendinopathy. Clin Orthop Relaf Res. 2006;443:320-332. http://dx.doi.org/10.1097/01.blo.0000195927. 81845.46
78. Warner JJ, McMahon PJ. The role of the long head of the biceps brachii in superior stability of the glenohumeral joint. J Bone Joint Surg Am. 1995;77:366-372.
79. Warren RF. Lesions of the long head of the biceps tendon. Instr Course Lect. 1985;34:204-209.
80. Weiser WM, Lee TQ, McMaster WC, McMahon PJ. Effects of simulated scapular protraction on anterior glenohumeral stability. Am J Sports Med. 1999;27:801-805.
81. Werner A, Mueller T, Boehm D, Gohlke E The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoana- tomic study. Am J Sports Med. 2000;28:28-31.
82. Wilk KE, Reinold MM, Dugas JR, Arrigo CA, Moser MW, Andrews JR. Current concepts in the recognition and treatment of superior labral (SLAP) lesions. J Orthop Sporfs Phys Ther. 2005:35:273-291. http://dx.doi.org/10. 2519/jospt.2005.1701
83. Yamaguchi K, Riew KD, Galatz LM, Syme JA, Neviaser RJ. Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res. 1997;122-129.