Biceps Tendonitis & Superior Labral Injury

Background

Biceps tendonitis and injuries to the biceps-labral complex often involve inflammation or degeneration of the long head of the biceps tendon (LHBT) and its attachment to the superior labrum of the glenoid. These conditions are commonly seen in overhead athletes or individuals performing repetitive shoulder activities, leading to overuse and microtrauma.

The biceps-labral complex plays a role in shoulder stability and motion, and injuries such as SLAP (superior labrum anterior to posterior) tears can compromise both function and comfort. These issues may also occur in conjunction with other shoulder pathologies, such as rotator cuff tears or shoulder instability.

Symptoms

Patients with biceps tendonitis or biceps-labral complex injuries typically report:

• • Pain in the front of the shoulder
• • Pain especially with overhead motion or lifting
• • Pain radiating down the front of the arm
• • Worsening with elbow flexion or forearm supination
• • Deep, catching, or clicking sensation within the joint
• • Weakness and reduced athletic performance
• • Possible tendon rupture in chronic cases

Diagnosis

Diagnosis begins with a detailed history and physical exam, including specific tests such as Speed's test, Yergason's test, and O'Brien's test to assess biceps and labral involvement.

Occasionally a diagnostic injection into the bicipital groove or the glenohumeral joint can be helpful to truly localize the source of symptoms. These injections can be both diagnostic and therapeutic. If symptoms persist despite non-operative care, an MRI can provide supporting evidence of biceps/labral disease and also evaluate for other sources of pain.

Treatment Options