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Injuries affecting the Upper Arm

Overuse injury of the long tendon of the biceps

Overuse injury of the long tendon of the biceps is usually secondary to another shoulder injury such as impingement or instability. The biceps injury is usually of a degenerative nature. Midsubstance degenerative changes in a tendon are referred to as tendinosis. This biceps tendon glides over the articular head of the humerus and leaves the joint through a special groove. When degeneration of the tendon occurs, tenderness at the uppermost part of the extremity is very noticeable. This injury occurs most commonly in canoeists, rowers, weightlifters, swimmers, javelin throwers, fencers, wrestlers, golfers, tennis players, table tennis players, badminton players, and squash players.

Symptoms and diagnosis

– Tenderness is felt over the anterior aspect of the upper arm and shoulder, especially when the elbow joint is flexed.
– Yergason’s and Speed’s tests are positive.
– In the acute stage tendon crepitus (creaking) can be felt over the anterior aspect of the shoulder during flexion and extension of the elbow.


The athlete should:
– gradually progress through a carefully planned exercise program;
– apply local heat and use a heat retainer after the acute phase and before activities.

The doctor may prescribe anti-inflammatory medication.


The injured person can resume sporting activity when symptoms have disappeared.

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