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The biceps muscle turns the palm from facing downwards to facing upwards and also bends the arm at the elbow. An injury to its surrounding structures can make your arm movements challenging.

Biceps tendonitis is an injury of the tough cord that connects to the biceps muscle and usually occurs at the shoulder joint. It frequently arises as a result of overuse or chronic "wear and tear" and poor shoulder movements.

Overusing your arm muscles refers to performing repetitive movements involving the arm without providing adequate rest periods for your arm.

When you overuse your muscles, you predispose them to injury and sometimes tiny tears occur in the muscle and the tough cord that connects to the muscle, and eventually an extensive damage occurs.

An individual with this condition may complain of pain on the front aspect of the shoulder joint.

What are the risk factors of biceps tendonitis?
Tendons are tough bands/cords which connect muscles to bones. Repetitive activities and overuse can injure tendons, leading to pain and difficulty in performing everyday activities.

Overuse activities which may predispose you to the condition include overhead movements such as throwing activities, performing activities above the shoulder joint such as painting a wall, among other things.

Usually when your muscles get tired, they alert you to take a break through pain or you may find that your movements have become much slower than before, or you may also notice that your arm does not seem to be as strong.

These are signals to take a rest and allow your muscles to recover; but most of the time individuals do the opposite and the end result is damage to the muscle and its surrounding structures such as the tendon.

It may also arise when faulty shoulder movements overload the surrounding muscle, leading to a strain on the bicep tendon. Performing activities such as press-ups or bench presses should also be done appropriately in order not to cause a strain on the shoulder joint.

What are the signs and symptoms?
Pain related to biceps tendonitis is usually felt over the front of the shoulder, and some individuals may complain that the pain is also felt in the arm but not usually beyond the elbow.

Typically, the pain is aggravated by overhead activity and is worse at night. Individuals affected by this condition may report a clicking or popping sensation in the affected shoulder.

The early symptoms include pain on lifting objects and during activities such as brushing your teeth. The pain is often aggravated by raising the arm or bending at the elbow joint.

Overusing your arm muscles refers to performing repetitive movements

Some individuals may also experience muscle weakness. There is also a degree of difficulty in performing everyday activities, and you may require assistance. You may also realise that the affected shoulder seems slightly swollen as compared to your other shoulder joint.

How is it diagnosed?
Proper diagnosis and early intervention are essential in the management of biceps tendon injury. A diagnosis is made based on the individual’s symptoms, history and a clinical examination.

During the physical examination, the individual’s pain is assessed, available movements of the arm, muscle strength and other specific tests involving the arm.

An ultrasound can assist to confirm the diagnosis of biceps tendon injury. Magnetic Resonance Imaging (MRI) can provide detailed images of the biceps tendon. X-rays may also be conducted to rule out other conditions such as broken bones.
To be continued...

The writer is a Senior Physiotherapist at the 37 Military Hospital,
panierus@live.com