The biceps muscle has two anchor points in the shoulder region. The biceps tendon is located in the front of the shoulder. It begins from the shoulder socket and exits the joint trough the biceps groove. The tendon becomes the long head of the biceps muscle. The short head of the biceps is a continuation of the conjoined tendon which begins at the front of the shoulder blade. Read more about the anatomy of the biceps.
When we become older, there is a greater chance of biceps tendon injuries because tendons lose their elasticity and become stiff as we age. Also the quality of the bloodstream to the tendon becomes lower. If you often work out the degeneration of the tendon will be slower.
There are several biceps tendon injuries;
- A tear in the tendon.
- The dislocation of the bicep tendon.
- The tendon impingement syndrome
- Tendinitis is an acute injury caused by overusing the biceps. This biceps injury also occurs as a chronic variant called tendinosis. Two weeks of rest will cure this injury. If you’re unlucky you can develop a type of biceps injury that last longer than 2 weeks, called tendinosis. If you do not let your biceps recover from an acute biceps injury it can lead to tendinosis.
If the tendon or tendon sheath is thickened the friction in the tendon sheath can cause an inflammatory reaction. This gives local pain at the front of the head and the acromion of the shoulder, and can be triggered by pressing the head of the shoulder near the sulcus. There is pain when lifting the arm when lifting in under grip (with palms of the hands forward).
The cause is often difficult to trace. The problem can stand alone, but can also be a part of the impingement syndrome (see next biceps injury) or present in combination with a rotator cuff tear (rotator cuff tears are tears of one or more of the four tendons of the rotator cuff muscles). X-rays and magnetic resonance imaging (MRI) may show fluid around the tendon. A local injection can confirm the diagnosis and sometimes cure the injury.
If an injection with a strong anti-inflammatory medication such as cortisone does not have lasting success or gives a negative reaction a surgery has to take place. If tendon abnormalities can be detected, the biceps injury can be cured by cleaning the tendon. When cleaning doesn’t help, the place where the tendon is attached to the shoulder-blade can be moved to a different location. Then the tendon will be detached from the biceps anchor and attached a little further on the sulcus at the top of the shoulder. The result is that the tendon now runs through the joint and not has to slide through the sulcus, and thus the problem is solved. This has no consequences for the position of the shoulder and the strength of the biceps.
The dislocation of the biceps tendon
The tendon of the biceps is located in the bicipital groove held by the transverse humeral ligament. If this ligament is deficient the tendon can dislocate. This can be seen with a MRI scan. The bicipital groove is seen to be empty, and the tendon can be identified medially. If the tendon cannot be seen then a complete tear of the tendon should be suspected.
A tear in the bicep tendon.
If the tendon cannot be identified with MRI then a complete tear of the tendon should be sought.
The bicep tendon impingement syndrome
You can diagnose the tendon impingement syndrome when a specific movement results in shoulder pain. You’ll often feel that something feels “pinched” or “impinged” when you move your arm.
Biceps tendon injuries examples
Here are some examples of biceps tendon ruptures.
This athlete is performing an dead lift while his left bicep tendon ruptures. Don’t worry, not very shocking video.
Again a bicep tendon tear because of a dead lift. Look at the face of the athlete, he’s surprised first and then he finds out his biceps tendon is ruptured.
A bicep tear because of a “strongest man” exercise, again a very surprised athlete. At first sight the trainer doesn’t recognise it and is pushing his student to go through with the exercise.