Tendinitis of the Shoulder
Tendinitis of the shoulder typically occurs in the subacromial space and is common due to the anatomy of the shoulder coupled with stressful activity assigned to the joint. The subacromial space is an area on the top of the shoulder formed by the coracoacromial arch. This arch is formed by the acromioclavicular joint, coracoacromial ligament, and acromion (outer edge of the shoulder blade).
The chief tendons of the shoulder, the rotator cuff and long head of the biceps, pass under this arch. Reduction of this space exposes the tendons to a high risk for friction, rubbing, and irritation, setting the stage for a case of tendinitis. Tendon problems usually emerge in individuals 40 to 60 years old but are increasingly being seen in young athletes as a byproduct of repetitive overuse.
Biceps Tendinitis
Biceps tendinitis is the inflammation of the upper biceps tendon. Several muscles and tendons keep the arm anchored in the shoulder joint, and the head of the humerus (upper arm bone) fits into the joint socket. One of these muscles is the long head of the biceps tendon that attaches to the glenoid labrum.
This tendon is responsible for bending the elbow (flexion), turning the forearm (supination), and raising the arm overhead. It is commonly irritated with repetitive overhead activities and routine lifting that may result in pain and weakness in the shoulder. Increased age can increase the potential for a rupture.
Causes of Biceps Tendinitis
Biceps tendinitis is most diagnosed as an overuse repetitive strain injury (RSI). Other high-risk activities or conditions that can lead to the development of biceps tendinitis include:
- Participating in activities requiring overhead motions like swimming, tennis, softball, and baseball.
- Repetitive strain injuries (RSI) at work are common in people performing activities habitually, such as assembly line work.
- Sudden injury to the region, like a fall on the shoulder.
- Patients suffering from rheumatoid arthritis may have an increased risk of tendinitis.
- Aging, which results in changes to tendon elasticity and circulation that increase susceptibility to injury and reduce the ability to heal.
- Postural factors, such as a forward head and shoulder posture, reducing the subacromial space, thus leading to irritation of the shoulder tendons.
- Overload injuries derived from lifting heavy objects or weight training.
- Weakening of the rotator cuff, causing a muscular imbalance resulting in shoulder impingement (pinching).
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