The long head of the biceps is one of the 2 tendons that form the biceps. Its name is in fact due to the characteristic of having two heads that merge into a single distal body, thus defining the unusual structure of this muscle.
The biceps flexes thanks to the action of the two tendons: The long head moves the arm away from the trunk (abduction) and rotates it inwards (internal rotation), while the short one pulls the arm towards the trunk (adduction). When both heads contract simultaneously they produce the flexion movement of the arm. But let’s find out more about this specific tendon:
As we have already stated, the biceps muscle is connected to the scapula by two tendons. The first, which is by far the largest, inserts into the coracoid, which is a small bony hook of the scapula. The second, thinner and called the long portion of the biceps, runs in a groove of the humerus, passes over the humeral head to insert into the upper part of the glenoid. The long head of the biceps is a single tendon, which attaches to the radial tuberosity at the elbow, the glenohumeral joint, and the coracoid process at the scapula. This can become inflamedparticularly during repetitive, excessively intense or traumatic activities.
The main pathologies
The main pathologies that cause the long head of the biceps – TantaSalute.it
Among the main pathologies we invariably have tendinitis. Tendonitis of the long head of the biceps is also called wallet syndrome, due to pain. The latter, in fact, appears as soon as he puts his hand in his back pocket, the place where his wallet is very often found. Long biceps tendonitis is often associated with supraspinatus tendonitis. It is also one of the rare tendonitis that often progresses to partial or even total rupture of the tendon.
Long biceps tendonitis has no age limit: it affects both the elderly and young people. The causes of this tendinitis are multiple: excessive weight lifting, falling resulting in shoulder injury, excessive use of the tendon, etc. It generally develops when the shoulder is overloaded (particularly during weight-throwing/weight-throwing sports, projectiles, or heavy work). and more rarely following a trauma. In most cases, this tendinitis appears after repetitive movements, especially in athletes (for example, tennis elbow tendinitis, also called “tennis elbow”). This also applies to people who work on assembly lines or who spend many hours in front of the computer.
Symptoms of long head tendonitis are similar to other tendinitis, with pain in the injured tendon. It should not be confused with triceps tendonitis, in which the pain is localized to the back of the elbow. In fact, in biceps tendinitis, the pain is localized in the front part of the shoulder joint, going down the arm. It is awakened during elbow flexion movements against resistance, when stretching the biceps brachii and when pressing on the tendon
The most frequent remedies
The initial treatment of this pathology is always medical and is similar to the treatment of rotator cuff tendon pain due to the close proximity of the long biceps to these tendons. Here is a very common first intervention:
They will come upon request prescribed analgesics accompanied by rest of the shoulder joint. Rehabilitation interventions (in particular the lowering of the humeral head) can also help relieve the pain linked to the inflammation of this tendon. Even infiltrations in the bicipital groove or in the joint, in the best of all, ultrasound-guided hypotheses can help provide relief.
In case of very acute tendonitis, surgery cannot unfortunately be ruled out. The operation consists in fixing the long portion of the biceps in its groove and removing the damaged part, thus allowing pain relief, recovery of mobility and normal use of the arm. It is performed arthroscopy, i.e. without opening the joint. They are practiced around the shoulder two or three small 5 mm incisions. A small camera is inserted through one of them to view the joint. Small instruments are introduced through the other incisions to cut the tendon and resect the infra-articular part. An anchor is screwed into the gutter, the threads mounted on this anchor are passed through the tendon and knotted together to apply it to the bone.
In the presence of cuff pathology, it is treated simultaneously with acromioplasty or repair. The procedure is performed under general anesthesia. Local-regional anesthesia may be associated with it. It lasts an hour on average and requires hospitalization for about 2 days. After the operation, a sterile dressing and splint are applied. Pain treatment will be implemented, monitored and adapted very carefully in the post-operative period.