Biceps subluxation is a very common and painful condition. It is associated with rotator cuff tears. The biceps are the muscles in the front of your upper arm and sometimes they can tear due to an injury which causes the bicep tendons to become unstable. This in turn causes the rotator cuff to tear in the front part of the shoulder.
What is Biceps Subluxation?
The biceps muscles are attached to the bone because of tendons. Two are located at the shoulder and one in the elbow.
At the shoulder, one attachment is located known as the long head. It is a thin tendinous structure that runs in a groove at the front part of the shoulder before entering the shoulder joint. The groove is surrounded by a bone on three sides and covered by the transverse humeral ligament.
The soft tissues that help in maintaining the position of the long head of the bicep tendons within the groove can get injured. This leads to the tendon getting partially dislocated in and out of its groove. This is known as subluxation.
What causes Biceps Subluxation?
Biceps subluxation is often caused due to the degeneration of the muscles and tendons. The inability of the upper portion of the subscapularis tendon of the rotator cuff. It can cause soreness and inflammation to the tendons.
When the individual is involved in heavy lifting work, sports involving throwing, weight lifting, or bodybuilding, biceps subluxation can occur if the shoulder and arm movements are not performed carefully.
Poor physical strength and flexibility can also cause biceps subluxation.
Injury in the past, trauma or damage to the upper arm, or degeneration due to old age can also cause biceps subluxation.
Symptoms of Biceps Subluxation
The symptoms of biceps subluxation are varied and affect individuals differently.
- Stinging feeling in the shoulder when rotating the arm inward or outward
- Pain or discomfort in the front part of the shoulder
- Limited range of motion and lower flexibility and strength
- Swelling and deformity
A mechanical clicking sound can be heard when rotating the arm.
Young individuals involved in high physical activity are prone to a greater risk of subluxation.
How is Biceps Subluxation diagnosed?
The patient’s history needs to be checked first and then the doctor will carry out a physical examination. The doctor will ask if the patient is involved in any strenuous activity or about their past trauma.
The doctor will check for tenderness and deformity in the bicep and will ask the patient to perform a range of motion to assess the stability and functionality.
A specific diagnosis can be concluded by asking the patient to raise their arm while the palm faces upward while keeping the elbow at their side. A click can be felt because of the tendon slipping into the groove.
X-rays are not advisable as they do not show the tendons. MRIs and Ultrasounds are preferred.
MRIs show the long head of the bicep tendon and the degenerative changes and tears that happen to the tendons.
Ultrasounds provide a clearer view for diagnosis as they show long head instability. While the ultrasound is placed directly over the bicipital groove, the patient’s shoulder is moved to check the changes in the position of the bicep tendon.
Treatment for Biceps Subluxation
Treatment for biceps subluxation depends on the severity of the pain.
Over the counter, anti-inflammatory medications are prescribed to reduce swelling and tenderness. Injecting the lining of the tendon will help in relieving the pain instantly and reduce the swelling. By reducing the inflammation, the tendon may remain unstable but no further treatment is required.
Physical therapy is important as it helps in strengthening the shoulder. It improves flexibility and restores the range of motion of the shoulder to its full functionality.
A surgical technique known as tenodesis can be performed. It involves the stabilization of the long head biceps tendon in the groove. It may involve either arthroscopic or open removal of a portion of the long head of the bicep tendon.
Surgical intervention as a last resort can be done as it has high success rates.
Physical therapy speeds up the recovery process of biceps subluxation. Surgical interventions take three or four months to recover. Extreme use of overhead motions should be avoided for a few days after the surgery.
Biceps subluxation is a very common problem with a very high success rate solution. Although it can be prevented during old age it can be cured and the functionality of the shoulder can be restored.