long head biceps tendon

3 min read 13-03-2025

The long head of the biceps tendon is a crucial structure in the shoulder and elbow, contributing to both shoulder stability and elbow flexion. Understanding its anatomy, common injuries, and treatment options is vital for athletes and individuals alike. This comprehensive guide explores everything you need to know about the long head of the biceps tendon.

Anatomy and Function of the Long Head of the Biceps

The biceps brachii muscle, located on the front of the upper arm, has two heads: the short head and the long head. The long head originates from the supraglenoid tubercle of the scapula (shoulder blade), passing through the shoulder joint and attaching to the radial tuberosity of the radius bone in the forearm. This unique pathway means it plays a dual role.

Shoulder Stability

The long head of the biceps tendon contributes significantly to shoulder stability. As it passes through the glenohumeral joint (shoulder joint), it acts as a dynamic stabilizer, helping to control the movement and position of the humerus (upper arm bone) within the glenoid fossa (shoulder socket). This is particularly important during overhead activities.

Elbow Flexion

Once it passes the shoulder, the long head of the biceps, along with the short head, becomes a primary flexor of the elbow. It also helps with supination (turning the palm upwards).

Common Long Head of the Biceps Tendon Injuries

Injuries to the long head of the biceps tendon are relatively common, especially in athletes participating in overhead sports like tennis, baseball, and swimming. These injuries range from minor tendinitis to complete tears.

Biceps Tendinitis

This involves inflammation of the tendon, often caused by overuse or repetitive movements. Symptoms include pain in the front of the shoulder, particularly during overhead activities. It might also cause tenderness to the touch around the bicep tendon.

Biceps Tendon Tear

A partial tear involves damage to some of the tendon fibers, causing pain and weakness. A complete tear results in the tendon completely separating from the bone, often accompanied by a noticeable "pop" and significant pain. A visible or palpable bulge might appear in the upper arm as the detached tendon retracts.

Subluxation and Instability

The long head of the biceps can also experience subluxation, meaning it partially slips out of the bicipital groove, a channel in the humerus where the tendon usually sits. This can lead to recurrent pain and catching sensations in the shoulder.

Diagnosis of Long Head of the Biceps Tendon Injuries

Diagnosing long head of the biceps tendon problems typically involves a physical examination by a physician or physical therapist. The doctor will assess your range of motion, strength, and palpate (feel) the tendon for tenderness or irregularities.

Imaging Techniques

Imaging techniques such as X-rays, ultrasound, and MRI scans can help confirm the diagnosis and assess the extent of the injury. MRI scans provide the most detailed images and are often preferred for evaluating tendon tears.

Treatment Options for Long Head of the Biceps Tendon Injuries

Treatment depends on the severity of the injury and the individual's activity level.

Conservative Treatment

For less severe injuries like tendinitis, conservative treatment is usually sufficient. This may include:

Rest: Avoiding activities that aggravate the pain.
Ice: Applying ice packs to reduce inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter pain relievers like ibuprofen or naproxen.
Physical therapy: Exercises to strengthen the shoulder muscles and improve range of motion.
Corticosteroid injections: Injections directly into the tendon sheath to reduce inflammation (should be used sparingly due to potential long-term side effects).

Surgical Treatment

Surgical intervention is generally considered for complete tendon tears or persistent pain unresponsive to conservative treatment. Surgical options include:

Tenodesis: The damaged tendon is reattached to a different anchor point on the humerus.
Tendon repair: The torn ends of the tendon are sewn back together.
Tenectomy: The damaged tendon is completely removed. This procedure is less common because it can weaken the shoulder and biceps.

Recovery and Rehabilitation

Recovery time varies depending on the severity of the injury and the treatment received. Conservative treatment might take several weeks, while surgical repair could require several months of rehabilitation. Physical therapy plays a crucial role in regaining strength and range of motion after both conservative and surgical treatment.

Preventing Long Head of the Biceps Tendon Injuries

Preventing injuries involves focusing on proper warm-up and cool-down routines, strengthening the shoulder muscles, and avoiding overuse. Maintaining good posture and proper technique during activities that stress the shoulder are also essential preventative measures.

Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with a healthcare professional for diagnosis and treatment of any medical condition.