PROXIMAL BICEPS TENDINITIS

Proximal biceps tendinitis refers to inflammation and irritation of the biceps tendon at the shoulder. The biceps muscle, located at the top of the arm, enables essential movements of both the shoulder and elbow. It consists of a long head and a short head, which function together. The long head of the biceps tendon attaches to the upper part of the shoulder, while the short head attaches to the shoulder blade.

What are the common causes of proximal biceps tendinitis?

Proximal biceps tendinitis may develop from repetitive overhead activities in sports such as baseball and tennis. It can also result from shoulder arthritis, glenoid labral tears, chronic shoulder dislocation, shoulder impingement, or general inflammation of the shoulder.

What are the signs of proximal biceps tendinitis?

Proximal biceps tendinitis may not cause symptoms at first. As the condition progresses, you may experience the following signs:

• Snapping of the shoulder
• Pain in the upper shoulder, which may extend into the upper arm.
• Pain when resting on the affected arm
• Weakened and stiffened arm
• Reduced range of motion of the affected arm

How to diagnose proximal biceps tendinitis?

Dr van Niekerk will examine your shoulder and ask you to perform specific movements to assess the problem. He will determine the location and extent of your pain to evaluate the severity of the condition. A detailed medical history will be collected, and imaging tests such as X-rays, CT scans, or MRI scans may be performed if necessary.

What are the treatment options for proximal biceps tendinitis?

Medications
Pain and inflammation associated with proximal biceps tendinitis can often be managed with medications. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to help relieve discomfort and reduce swelling. In some cases, stronger pain medication may be recommended for short-term relief when symptoms are more severe.

RICE Therapy
Conservative treatment usually begins with the RICE method, which helps reduce pain and supports healing.

• Rest: Avoid activities that place strain on the shoulder, especially overhead movements, to prevent further irritation of the tendon.
• Ice: Applying an ice pack to the affected shoulder for 15–20 minutes several times a day may help ease pain and limit swelling. Ice should always be wrapped in a towel before application.
• Compression: Using a compression bandage or supportive shoulder wrap can assist in reducing swelling and provide additional support to the joint.
• Elevation: Keeping the shoulder slightly elevated whenever possible may help minimise swelling and improve comfort.

Physical Therapy

A physiotherapy program is often recommended to restore shoulder movement and strengthen the surrounding muscles. Specific exercises are used to improve flexibility of the acromioclavicular (AC) joint, enhance shoulder stability, and gradually restore normal arm function.

Surgical Treatment

If symptoms continue despite conservative management, arthroscopic shoulder surgery may be considered. During this minimally invasive procedure, a small camera called an arthroscope is inserted into the shoulder joint through tiny incisions, allowing the surgeon to clearly view the affected structures on a monitor.