Although the bicep is one of the most recognized muscles, injuries to this muscle are most commonly associated with the tendons of the bicep that connect it to the bone. The upper tendons (proximal tendons) attach at specific shoulder locations, while the distal tendon (lower end, closer to the hand) crosses the elbow and attaches in the forearm.
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In the case of Bicep Tendonitis, overuse or prolonged repetitive motion can stress these tendons, leading to a tendonitis or a strain condition in which the tendons become inflamed and irritated. This Tendonitis can lead to significant pain and weakness of the upper extremity. The most common point of tendonitis is in the front of the shoulder over the long head of the bicep tendon.
Avoiding activities involving repetitive flexion (bending) of the elbow is typically recommended to assist in resting the inflamed biceps tendon. If pain increases, you should seek prompt medical attention. Your physician may recommend anti-inflammatory medications or injections to assist in healing. A comprehensive therapy program may also be prescribed, incorporating specific exercises, treatments, and modalities to address the Tendonitis and help in regaining mobility, strength, and function.
The more severe bicep injury is the Bicep Tendon Rupture, of which there are two major types:
1. Proximal Bicep Tendon rupture.
2. Distal Bicep Tendon rupture.
Distal Tendon Ruptures are more common and often affect men of middle age. These injuries occur when extreme and sudden forces are placed on the biceps unit (such as lifting a heavy crate, pulling on a heavy rope, or weightlifting), causing the tendon to rupture from the attachment site in the forearm. This injury is usually required to be repaired surgically since there would be a significant decrease in elbow strength and function. Following surgical repair the patient will usually be prescribed therapy (including splinting) to ensure proper healing to avoid re-rupture and eventually progress into regaining strength & endurance. This should enable the patient to resume normal activities.
Proximal Tendon Ruptures are rare injuries that most often occur in older adults suffering from degenerative shoulder conditions. In most cases, the individual is already suffering from shoulder pain which has previously altered the normal mechanics of the shoulder unit. In rare conditions a rupture can occur at one of the proximal tendon attachment sites. The patient may or may not experience pain from the injury, but it is common to notice a small bulge in the upper arm from the retracted tendon. Surgical repair for this injury is typically not pursued unless the patient is extremely active or young.
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