Ortho 2 Exam 2 (LLAF and shoulder) --> Shoulder Conditions (bicep tendon pathology)

what is the long head biceps a passive restraint to?

- superior anterior translation

- LH biceps is a secondary stabilizer for GH joint

what are the conditions of the biceps tendon? (6)

- tendinopathy

> tendinosis: degenerative

> tenosynovitis and tendinitis: acute inflammatory problem

- proximal tendon rupture

- subluxing tendon

what is the mechanism of proximal biceps tendinopathy? (1)

- result of primary or secondary impingement syndrome

what is the mechanism of long head biceps instability? (3)

- subluxation of tendon out of the bicipital groove

- tearing of the transverse humeral ligament (runs transverse and holds the biceps tendon in place)

- shallow groove

what is the mechanism of a proximal biceps tendon rupture? (1)

- result of chronic tendinopathy

what are some symptoms that are associated with proximal biceps tendinopathy?

- anterior shoulder pain

- can have weakness

what are some symptoms that are associated with long head biceps instability?

- anterior shoulder pain

- popping sound as tendon subluxes from bicipital groove

what are some symptoms that are associated with proximal bicep tendon rupture?

- elbow flexion and supination weakness

- can have pain

- might have no pain due to relief sensation from the rupture

- popeye deformity (looks like an apple that has a bite taken out of it)

what tests and measures should you do for proximal bicep tendinopathy?

- same as shoulder impingement syndrome

what tests and measures should you do for long head bicep instability?

- reproduction of subluxation with medial and lateral rotation

what tests and measures should you do for proximal biceps tendon rupture?

- (+) Ludington's test

> patient seated with hands behind head (beach relax position)

> palpate the tendon and apply resistance to confirm

- visual evidence of popeye deformity

what are nonsurgical options for proximal biceps tendinopathy?

- same as for SAIS

- eccentric shoulder and/or elbow flexion

what are nonsurgical options for long head bicep instability?

- non-surgical rehab was NOT successful in athletes

what are nonsurgical options for proximal biceps tendon rupture?

- decrease swelling

- restore ROM and strength

(is possible to rehab without surgery... Bennett did it)

what are surgical options for proximal bicep tendinopathy?

- SAD (shave off bottom of acromion to make more space in the joint for bicep tendon)

- tenotomy (cutting away at the tendon) /tenodesis (reattach bicep)

what are surgical options for long head bicep instability?

- reconstruction of transverse humeral ligament (THL)

what are surgical options for proximal bicep tendon rupture?

- surgery is rarely considered