Biceps Tendinitis

 Understanding the Condition and Ultrasound-Guided Cortisone Injection Approach at Joint Injections

Introduction

Biceps tendinitis is a condition that involves inflammation or irritation of the tendon that connects the biceps muscle to the shoulder. It is a source of discomfort for many individuals, particularly those engaged in repetitive overhead activities or weightlifting. Although frequently manageable with conservative strategies, persistent symptoms may necessitate more targeted interventions.

At Joint Injections, we offer ultrasound-guided cortisone injections as a precision-based approach to address symptoms linked to biceps tendinitis. This blog provides an in-depth look into the anatomy, causes, symptoms, diagnosis, and management options for biceps tendinitis, with a focus on our technique.

Anatomy of the Biceps Tendon

The biceps muscle, located in the front of the upper arm, has two tendons that attach it to the shoulder:

  • Long head of biceps tendon: This tendon travels through the bicipital groove and attaches to the top of the shoulder socket (glenoid).
  • Short head of biceps tendon: This attaches to the coracoid process, a bony projection on the shoulder blade.

The long head of the biceps tendon is more commonly involved in tendinitis due to its course through the shoulder joint and exposure to repetitive movement and strain.

What Is Biceps Tendinitis?

Biceps tendinitis refers to inflammation of the long head of the biceps tendon. Over time, the inflamed tendon may become thickened, frayed, or degenerated. The condition can occur in isolation or as part of a broader spectrum of shoulder pathologies, such as rotator cuff disorders or shoulder impingement.

Causes and Contributing Factors

Several factors can contribute to the development of biceps tendinitis:

  • Repetitive Overhead Motion: Common in athletes (e.g., swimmers, tennis players, or baseball pitchers) or those with overhead occupations.
  • Degeneration with Age: Tendons naturally weaken over time and may develop microtears.
  • Poor Posture or Biomechanics: Improper lifting techniques or shoulder mechanics may increase strain on the biceps tendon.
  • Coexisting Shoulder Conditions: Including rotator cuff tears, shoulder impingement, or labral injuries.

Symptoms

Individuals with biceps tendinitis may experience:

  • A deep, aching pain in the front of the shoulder
  • Pain aggravated by lifting, pulling, or overhead activity
  • Tenderness over the bicipital groove
  • A snapping or popping sensation
  • Weakness when bending the elbow or rotating the forearm

Diagnosis

A comprehensive clinical assessment is essential for diagnosing biceps tendinitis. This typically involves:

  • Patient History: Including the nature, onset, and duration of symptoms.
  • Physical Examination: Specific tests such as Speed’s or Yergason’s test may reproduce symptoms.
  • Ultrasound Imaging: At Joint Injections, ultrasound is often used to visualise tendon inflammation, thickening, or structural changes, aiding in both diagnosis and injection guidance.

Conservative Management Options

Initial treatment options may include:

  • Rest and Activity Modification: Avoidance of overhead activities or heavy lifting.
  • Ice Therapy: To reduce inflammation.

Ultrasound-Guided Technique at Joint Injections

Ultrasound guidance provides several advantages:

  • Accurate Visualisation: Ensures the injection is placed around the biceps tendon, avoiding surrounding structures.
  • Minimally Invasive: The technique involves a fine needle and is typically well tolerated.
  • Real-Time Feedback: Allows clinicians to monitor the spread of the medication and confirm optimal placement.

What to Expect During the Procedure

At your appointment:

  1. A clinician will assess your shoulder and confirm the diagnosis.
  2. The area will be cleansed, and local anaesthetic may be applied.
  3. Using ultrasound, the clinician will guide a fine needle to the affected tendon sheath.
  4. A mixture of corticosteroid and local anaesthetic is injected around the tendon.
  5. Post-procedure care instructions are provided.

The procedure is usually completed in a short duration, and patients may resume light activity the same or following day, depending on clinical advice.

Benefits of Cortisone Injections

Corticosteroid injections are used in various musculoskeletal conditions to help address local inflammation. In biceps tendinitis, the goal is to reduce the inflammatory process surrounding the tendon, thereby supporting function and comfort levels.

Patients may report:

  • A reduction in local tenderness
  • Greater ease with daily activities

Additional Considerations

  • Avoidance of Aggravating Activities: Especially in the days following the injection.
  • Review and Follow-Up: To assess response and guide further management.

When Other Conditions Coexist

Sometimes, symptoms resembling biceps tendinitis may stem from:

  • Rotator cuff tears
  • Labral lesions (SLAP tears)
  • Shoulder impingement

In such cases, a more comprehensive treatment plan is developed by the clinician.

Why Choose Joint Injections for Ultrasound-Guided Injections?

At Joint Injections, our clinicians focus on precision-guided treatments. We provide:

  • Ultrasound-guided injections performed by trained clinicians
  • A patient-centred environment
  • Thorough assessments and explanations
  • Integration with allied rehabilitation services if needed

Every case is considered individually, and a collaborative approach is followed for appropriate treatment planning.

Final Thoughts

Biceps tendinitis is a condition that can interfere with daily activities and exercise routines. With early recognition and appropriate management — including the use of ultrasound-guided cortisone injections when suitable — individuals may experience improvement in symptoms and function.

If you suspect biceps tendinitis or are experiencing persistent shoulder discomfort, a tailored assessment at Joint Injections may assist in identifying an appropriate course of action.

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