Inflammation of the long tendon of Biceps Brachii (b.b), and its enveloping sheath (tenosynovitis).
Causes: The causes of bicipital tendinosis are subdivided into two categories;
1) subluxating tendon associated with a tear or laxity of the transverse humeral ligament, thereby allowing excessive motion of the long b.b tendon within the bicipital groove,
2) antero-superior impingement the result of abnormal gleno-humeral biomechanics, a shallow bicipital groove, superior humeral translation, and/or overuse such as repeated over-head activities.
Presentation: Patients suffering from bicipital tendinosis classically present with localised pain within the proximal bicipital groove, which may be accompanied by heat and oedema.
Orthopaedic tests for bicipital tendinosis:
Speed’s test: With the patient’s elbow completely extended, supinated, and the shoulder flexed forward at 45, the practitioner palpates the biciptal groove with one hand while resisting active elevation of the patients same arm with the other. Pain within the proximal bicipital grove represents a positive.
Yergason’s test: This test evaluates the integrity of the transverse humeral ligament. With the patient seated and the elbow flexed at 90, stabilise the patient’s elbow with one hand whilst holding the patient’s wrist with the other. Instruct the patient to externally rotate the shoulder, flex the elbow and supinate the wrist whilst resisting this movement. A snapping sound and or pain within the bicipital grove indicate a positive test