The biceps muscle has two tendon origins in the shoulder area, one of which starts at the upper end of labrum (socket cartilage) inside the joint. The Long Head of the Biceps, as this origin is known, is often subject to extensive traction forces, and gets irritated as it rubs on the bony surface of the humeral head. As it exits the shoulder joint and moves down the arm it makes a 90 degree downward turn which can lead to increased stress on the tendon. This condition is known as Biceps Tendinitis. Ligaments that keep the biceps tendon in position (in a bony groove) will sometime degenerate, allowing the tendon to slide out (sublux) out of its original place on the bone, causing biceps instability. This can be precipitated by a traumatic event, like a fall on an outstretched arm.

Biceps tendon inflammation and/or associated instability (subluxation or dislocation), typically results in pain in the front of the shoulder that can radiate down the front of the arm. This pain is often worse with certain movements, including shoulder rotation, reaching behind the back, and resisted elbow flexion (i.e. biceps curls). Furthermore biceps instability often leads to popping or catching sensations in the front of the shoulder. Biceps instability is also frequently associated with other shoulder pathology, including rotator cuff tears, SLAP tears and shoulder dislocation.
Biceps lesions are typically diagnosed by the patient’s history and careful physical examination. The lesion can be confirmed by an MRI or an Ultrasound .
The treatment of biceps tendinitis usually start with conservative options line medications, injections and physical therapy. Biceps instability is usually treated surgically. Surgical treatment options include:

1) Biceps tenotomy: cutting and releasing the long head of the biceps tendon so that it no longer slides in and out of the bicipital groove causing pain and a popping.

2) Biceps tenodesis: cutting the tendon at its origin, resecting a portion of the tendon, and reattaching the remainder of the tendon to the upper arm bone further down the arm below the bicipital groove so that it no longer slides in and out of the bicipital groove causing pain and popping.

At Oceana Sports Medicine and Orthopaedic Center, Dr Aboka performs minimally invasive, all-arthroscopic treatment for biceps conditions through keyhole incisions. This cutting-edge technique allows for thorough inspection of the shoulder joint, and facilitates identification and treatment of other painful conditions that may be present, ensuring return to good shoulder function. This procedure is outpatient/same-day surgery, and leads to less pain and scarring and quicker recovery.