You can feel your biceps muscle at the front of your arm when you bend your elbow and turn you palm towards your face. This muscle inserts as one fused tendon into your forearm, but has two distinct tendons at its upper end. The main tendon (short head) at the upper end inserts into the coracoid process of your shoulder blade. This is outside of your shoulder joint and rarely causes problems. The second, less functionally important ‘long head’ tendon, passes through the shoulder joint on its way to the top of the glenoid (the socket of the shoulder) where it inserts into bone. It is this long head that frequently contributes to pain in the shoulder and sometimes ruptures. Your biceps muscle has two functions: one is to help bend your elbow, the second is to provide twisting power in your forearm (supination) (e.g. screwdriver use).
Long Head of Biceps tendinopathy
Often patients report a gradual onset of pain felt at the front and inside the shoulder, which is made worse by pulling up your arm (weight training) or on twisting your forearm (e.g. screwdriver). They mat also have a painful area at the front of their shoulder
Ruptured Long Head of Biceps
A degenerate tendon can rupture causing the muscle to retract down the arm. This can alter the contour of your biceps to give a ‘Popeye Sign’. Patients typically describe a sudden tearing and pain, sometimes with bruising tracking down their arm. Normally however, there is then resolution of symptoms after a few weeks, often when the patient has had a previously irritable shoulder. Occasionally active patients (e.g. manual workers) complain of cramping in their arm when doing repetitive tasks after long head of biceps rupture,
Proximal biceps tendon problems are rare in the under 40’s. If young people do get symptoms, it may be due to incorrect sports technique, or shoulder motion problems. ‘Cross-fit’ and other intensive strength training programmes may overload the biceps tendon and cause symptoms. A superior labral (SLAP) tear can also affect the long head of biceps insertion. Degenerative tendinopathy generally occurs in patients aged over 40 years, becoming common as we get older than 65 years. Degenerate proximal biceps problems may co-exist with rotator cuff tears.
A degenerate long head of biceps tendon is a potent pain generator in the shoulder. If your symptoms haven’t settled with non-operative measures, then you may require surgery. Sometimes your problem with the biceps tendon accompanies other problems in your shoulder that need surgical treatment. The biceps may also be noticeably damaged at surgery, in which case it is better to have it dealt with.
Making the right choice about the best treatment for you means getting the right information. During your consultation, please do feel free to ask Mr Granville-Chapman to explain anything that you do not fully understand, and for his advice about the pros and cons of any treatment.
Mr Granville-Chapman was very polite and his examination and explanation of my symptoms and expected treatment was thorough
I found Mr Granville-Chapman to be very knowledgeable and professional. He put me very much at ease and explained all the options that I have thoroughly. He also told me to look for further information on the condition and procedures that I needed on his website, which gave lots of information and detail. It was also easy to understand for those without a medical background. I would highly recommend his services to anyone that has shoulder problems and requires a solution.
I attended for a repair of my right bicep tendon. After a thorough examination, Mr Granville-Chapman arranged an operation to be undertaken within 2 days which was extremely quick; he explained his reasoning which was both thorough and reassuring, explaining both the options of undergoing surgery and deciding to undertake conservative management.On the day of the surgery Mr Granville-Chapman was again very reassuring as although this is minor surgery I was still somewhat apprehensive. He came to fully explain the procedure and afterI woke up was quick to check on how I was doing.Overall I am very happy with the careMr Granville-Chapman
I have been very pleased with my treatment so far. Mr Granville-Chapman combines brisk efficiency with a pleasant, sympathetic manner. My operation, however, is still to come ...
From the initial consultation, through surgery on a fractured wrist, and now post-operative follow up, it has been a very positive and reassuring experience with Mr Granville-Chapman. I would have no hesitation in recommending him to someone else.
A first class clinician. A skilled surgeon with an excellent bedside manner.
A very pleasant Consultant who knows exactly how to make pain go away.
Mr Granville - Chapman has an excellent bedside manner. He engaged with my 12 year old son at an appropriate level and took the time to ensure that he understood the procedure and answer all his questions. He is thoroughly professional and I would not hesitate to recommend him.
I have been very pleased with the attention I have received. Mr. Granville-Chapman has reassured me that my symptoms are normal. It is very easy to make appointments that suit me.
Mr Granville chapman I found be caring informative and professional I would recommend him to all if you have a problem don't hesitate to contact him you won't be disappointed.
I recently broke my right clavicle in a mountain bike accident and it was repaired by Mr Granville-Chapman by adding a plate on top of the bone. Having just finished the last post-op consultation, I can confirm that I have been very happy with the process all along. In particular, Jeremy took time to explain in detail why a plate was needed, what the procedure would entail, and also was very patient answering my questions comprehensively beforehand and after during the recovery phase. Would certainly trust this competent surgeon to fix any future fractures I might sustain.
Mr Granville-Chapman has looked after my 15 year old son brilliantly, explaining the surgery, recovery and best way forward, and Kate has been very supportive helping with logistics etc, thank you so much.
So far my experience with Mr Jeremy Granville-Chapman has been personal and informative with regard to the operation I will be having. I feel confident that my operation will be a success and for this reason I am very happy to have Mr Jeremy Granville-Chapman as my consultant.
Very knowledgeable and helpful. Takes the time to make sure you're getting the treatment you need.
Mr Jeremy Granville -Chapman is not only a highly skilled consultant but is able to put you straight away at ease .My appointments were arranged very swiftly which was great, when you are experiencing severe pain. I am very happy with my treatment so far . many thanks to everyone who was involved in my treatment.
Polite, helpful, professional. Makes an effort to ensure full understanding of issues and procedures to be done. Highly satisfied
Very pleasant. Clear, careful explanations & options/possibilities. I feel well informed, and happy that my concerns are being well addressed, with a plan of review of the symptoms.
Excellent advise with everything explained clearly and a successful treatment which has benefited be greatly.
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