Anterior shoulder pain, long head of biceps and SLAP tears with Jo Gibson

Long head of biceps (LHB) tendinopathy and associated anterior shoulder pain can develop in patients that increase their lifting load eg moving house, overhead activities, activities that involve loaded shoulder extension and in throwing athletes. Patients may also develop long head of biceps tendon pain after a traumatic ACJ injury or SLAP tear.
How can you identify and treat LHB tendinopathy? In this video with Jo Gibson, you’ll explore:
What causes LHB tendinopathy?
- What mechanisms of injury commonly cause LHB pain, ACJ injury or SLAP tears?
- Key traumas you need to keep an eye out for that impact LHB
- Why do patients with ACJ injuries develop LHB pain?
- Why do patients with SLAP lesions develop LHB pain?
- What causes LHB reactive tendinopathy?
LHB Anatomy & function
- What activities does LHB help with?
- Long head of biceps (LHB) anatomy
- Variance in proximal biceps attachment and how traumatic LHB injuries impact different structures
- How the LHB is stabilised anatomically in the bicipital groove
- Does the transverse ligament exist?
Patient features that help your diagnosis
- Which patients are likely to present with LHB pain?
- Which structures are more likely to be affected with traumatic shoulder injuries in younger vs older patients?
- Why do young patients with LHB instability develop pain?
Subjective history features that help your diagnosis
- Where do patients with LHB tendinopathy experience pain?
- Which movements are likely to be painful in LHB tendinopathy patients?
Objective testing & diagnosis
- Which tests or combinations of tests help diagnose LHB pain?
- Which special tests help your diagnosis?
- Does palpation have any value in LHB diagnosis?
- How can you exclude intra-articular pathology with your testing?
- How can you rule in or rule out rotator cuff pathology?
Rotator cuff tears & involvement in LHB
- How does LHB muscle activity vary in painful vs painfree massive rotator cuff tear patients?
- How do traumatic rotator cuff tears, particularly subscapularis, impact LHB?
- If patients have rotator cuff surgery, what details in the operation notes will help you identify if they are at risk of persistent post-op pain and stiffness?
- Why do subscapularis tears cause LHB pain?
Imaging
- What information does imaging of LHB provide?
- What imaging can you use if your patient is not progressing?
- MRI vs MRA vs US for different pain & injuries
How to treat LHB
- What is the best way to treat LHB tendon pain?
- Are isometrics helpful with LHB, and how do these help?
- What surgery is used for LHB pain?
Additional question covered:
- How are results after rotator cuff tears impacted by the rotator interval?
Links associated with this video:
* Accurately assess, diagnose & treat frozen shoulder, with this free videos series from Jo Gibson www.clinicaledge.co/shoulder
* Improve acute shoulder pain diagnosis with 3 free videos from Jo Gibson www.clinicaledge.co/shoulder
* Comprehensively assess and treat shoulder pain with the Shoulder: Steps to Success online course at clinicaledge.co/shouldersuccess
* Improve assessment & treatment for all other musculoskeletal and sports injuries with a free trial Clinical Edge membership www.clinicaledge.co/sign-up
* Infographics by Clinical Edge www.clinicaledge.co/blog

[@mindovermovement6401]

Thanks

[@williamb6698]

Very helpful information, thank you for this video!

[@joesefr.7756]

Soo useful

[@ErinM-2024]

I have been told that I have rotator cuff tendinosis possibly a slap tear, possibly a rotator cuff tear. I have been told I have a c joint problems. The front of my shoulder where the biceps is, is in so much pain. I fell on my shoulder back in 1999. I’m 42 now. I will be starting p t in august. If p t doesn’t work, then I will be having surgery

[@philipmullins5185]

I have a rupture of the long head tendon of the biceps and tears in the three of the four rotator cuff muscles , there is a difference between having a pathology showing in those muscles and tendon and actually pin pointing exactly where the pain is coming from .
I would like to know exactly why the pain occurs , is it because of inflammation in the soft tissue or is it because the tendon is injured or twisted and it is not sitting correctly on the bone structure so when the shoulder is moving , the tendon is compressed against the bone which causes pain from the nerves that are situated in that area ?

[@Rollwithit699]

My left inner anterior shoulder burns deeply, worse at night and when I wake and am very stressed. I sleep very poorly anyway and wake with deep burning there and often down to elbow and down forearm to top of hand. What the heck? How do I fix this?

[@guuskonijn4108]

Exactly the same problem here, did you find what you have? and is your pain gone now?

[@Rollwithit699]

@@guuskonijn4108 I was just diagnosed with small fiber neuropathy. Also am being tested for Sjogrens and possibly something else autoimmune, according to first visit with a rheumatologist. Good grief. Have read a lot lately how this can be controlled or nearly reversed with stress control and a diet called GAPS. I'm definitely trying it. Fingers crossed. Good luck to you too.

[@GoodByeSkyHarborLive]

@@Rollwithit699 what test did they use to diagnose it?

[@Rollwithit699]

@@GoodByeSkyHarborLive Last month I finally saw a neurologist who diagnosed me with small fiber peripheral polyneuropathy, migraines, and ulnar nerve entrapment. He said the nerve conduction and EMG studies, along with the symptoms were classic for those.
So...good grief. At least I know it's not anything terminal. Thinking of doing ketamine therapy.