Shoulder pain? Watch out for a torn tendon

Biceps tendinitis

Today's case is a middle-aged woman with pain in her left shoulder and a feeling of weakness when raising her arm. Her history showed that she had previously had surgery on her right shoulder and then used her left shoulder instead, carrying things to work and carrying shopping bags, until she began to feel pain at the front of her left shoulder when raising her arm or carrying heavy objects. Nothing looked abnormal from the outside, but palpation revealed a tender point at the front of the shoulder joint, an area known as the Bicipital groove. On examination she could still raise her arm fully, but when she pushed against resistance she immediately felt pain at the front of the shoulder.

An examination with diagnostic ultrasound (Ultrasound Diagnosis) showed not only inflammation of the Biceps tendon but also degeneration of the Rotator cuff muscles. In this case, the inflammation of the Biceps tendon was chronic, building up little by little, and may have caused the degeneration of the muscles (Degenerative), resulting from continuous repetitive use and increasing age. In addition, tendons receive less blood supply than muscles, which are much better supplied with blood, so tendon injuries take a long time to recover.

Physical therapy treatment includes

·  High power laser therapy to reduce pain and speed up the repair of the inflamed tendon

·  Once the pain has eased, exercises for the Rotator cuff muscles and the muscles around the shoulder to stabilise the shoulder joint

Self-care in daily life

· Avoid lifting heavy objects of any kind, because using the painful arm will inflame the tendon even more.

· Apply a cold compress to the painful area for 15 minutes to reduce inflammation.

Tips

ØWhat is the Bicipital groove? The Bicipital groove is a groove on the head of the upper arm bone at the shoulder joint where the Biceps tendon sits.

ØWhat is the Biceps muscle?  The Biceps, or Biceps brachii, is the muscle that bends the elbow.

ØSo when the Biceps is used to bend and straighten the elbow repeatedly, the Biceps tendon rubs against the Bicipital groove, which causes inflammation.

ØWhat are the Rotator cuff muscles? The Rotator cuff is a group of 4 muscles that stabilise the shoulder joint.