Long head of biceps (LHB) tendonitis / rupture

What is it?

The long head of biceps is one (of the two) heads of the biceps muscle. It is an unusual tendon as it passes though the shoulder joint to attach at the top of the glenoid (cup) of the shoulder at the labrum (a washer-like structure which deepens the shoulder cup).

What is it?

The long head of biceps is one (of the two) heads of the biceps muscle. It is an unusual tendon as it passes though the shoulder joint to attach at the top of the glenoid (cup) of the shoulder at the labrum (a washer-like structure which deepens the shoulder cup).

What causes it?

Tendonitis can be simply due to overuse but is often a sign of other problems with the shoulder is such as issues with the rotator cuff.

Long head of biceps rupture is commonly seen in middle aged men – but not always! It often occurs with relatively little trauma although can be due to severe injuries in younger individuals. It often gives individuals a typical ‘Popeye’ appearance to the bicep.

What happens if you do nothing?

If the tendonitis is simply due to overuse – reducing this should help your symptoms. However, if there is an another reason and the tendonitis is simply a sign of problems these may need to be diagnosed before you can start to get better.

When there appears to be a LHB rupture, it is important to identify that there has not been a tear in the rotator cuff as well. Long head of biceps rupture causes a little loss of strength with elbow flexion but is generally well tolerated.

What happens if you do nothing?

If the tendonitis is simply due to overuse – reducing this should help your symptoms. However, if there is an another reason and the tendonitis is simply a sign of problems these may need to be diagnosed before you can start to get better.

When there appears to be a LHB rupture, it is important to identify that there has not been a tear in the rotator cuff as well. Long head of biceps rupture causes a little loss of strength with elbow flexion but is generally well tolerated.

What treatments are there?

Physical therapies, steroid injections and surgery for resistant cases (either lengthening the tendon ‘tenolysis’ or detaching and reattaching ‘tenodesis’) can all help LHB tendonitis. Physical therapy can be helpful when there has been a ruptured LHB and in rare high demand individuals reattachment is an option.