Shoulder pain can also be associated with the pathology of the head of the long biceps, which can be divided into: chronic and acute. Chronic pathologies include various types of inflammation associated with the anatomical arrangement of the tendon, which runs in the area of the subbar calcaneus and the tendon of the epigastric muscle.
The second chronic pathology is the instability of the head of the long biceps due to, for example, partial damage to one of the rotator tendons or damage to the ligaments that hold the head of the long biceps in the groove. Acute pathologies include tearing of the head of the long biceps, which occurs quite often. Occurs this head in the course of degenerative changes of this tendon.
- pain in the shoulder joint,
- limitation of movement of the shoulder joint, especially internal rotation – reaching
- back, putting your hand in the sleeve, external rotation with a visit – patients have problems with clasping the bra,
- palpation pain in the groove of the head of the long biceps.
The basis of the diagnosis is a properly conducted subject examination, which allows you to save time in case of need for surgical treatment. Your doctor may perform several tests, such as the speed test or the yergason test. During the diagnosis, the doctor may extend the physical examination to include an imaging diagnosis.
The onset of the pathology of the head of the long biceps muscle and the course of the mediastinum can be seen using magnetic resonance imaging (MRI). In contrast, in the case of instability caused by damage, ultrasound is more effective, since it is a dynamic examination that can more clearly show the unstable part of the tendon. The most accurate examination of the pathology of the head of the long biceps muscle is arthroscopy.
In the treatment of most pathologies of the tendon of the head of the long biceps muscle, causing burdensome shoulder pain, good results are given by complex physiotherapy. An exception may be structural damage with signs of instability of the tendons or rupture of the rotator cuff. Sometimes, in case of prolonged inflammation, it is necessary to inject a steroid. Tendon rupture of the head of the long biceps very rarely requires surgical treatment. The procedure is performed mainly in young athletes or in special situations.
Chronic pathologies are surgically treated, where the doctor can perform tenotomy (dissection of the head of the long biceps) or tenodesis (a procedure consisting in stabilizing the head of the long biceps and excluding the shoulder from mechanical work). Thanks to this, the inflammation is “muted”, depriving the patient of shoulder pain.