Diagnosis and Treatment
If it is suspected that you may be suffering from a biceps injury, Dr. Boykin will perform a physical examination of the shoulder in addition to X-rays to determine the severity of the injury and whether other areas of the shoulder are affected. Specific physical exam tests for biceps tendon injuries include the Speed’s test, Yergason’s test, and tenderness over the biceps groove. In certain cases a MRI is needed to visualize the course of the tendon, areas of injury, and damage to other parts of the shoulder (including the rotator cuff). If the diagnosis is consistent with tendonitis or a strained tendon, Dr. Boykin will usually recommend non-surgical measures including:
- Anti-inflammatory medications (oral or topical gels)
- Injection of corticosteroids
- Physical therapy
- Change in daily routine to avoid actions that may inhibit the healing process
Surgical Treatment for a Proximal Biceps Tendon Injury
If a complete proximal tear is present within the biceps tendon, then surgery will be discussed. In certain cases the pain will resolve with non-operative measures and the patient will be able to function well without surgery. If the patient has weakness, cramping, continued pain, and/or a bothersome visible deformity then surgery will be considered. Acute proximal biceps injuries can be repaired using a combination of arthroscopic and mini-open surgery with small incisions on the front of the shoulder. The area of diseased tendon is removed and the remaining healthy tendon is attached securely back to the bone. In cases where the tear is more chronic, a larger incision may be necessary to safely free up the tendon from the built up scar tissue.
In cases of continued pain with biceps tendonitis that have failed non-operative measures, partial tears, and tears associated with rotator cuff disease, surgery may also be considered. This procedure consists of a combination of arthroscopic and mini-open surgery to remove the diseased area of the tendon and reattach the healthy tendon to bone outside of the shoulder joint to prevent problems later. This procedure has been shown to be highly successful in alleviating the pain associated with biceps disease while preserving the normal motions of the shoulder.
For more information about biceps injuries and the appropriate treatments, please contact orthopedic shoulder, knee, and hip surgeon Dr. Robert Boykin, treating patients in Asheville, Arden, Fletcher and surrounding North Carolina communities.