Richard Stockton College Athletic Training
Common Athletic Injuries
 Following is some information on injuries that athletes frequently encounter.
It is brief and to the point, not a detailed medical analysis of an injury.  Therefore use
the information accordingly.

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Biceps Tendinitis 
By Caroline Unger, MSPT, CSCS, EMT.  Caroline is a Physical Therapist at Genesis ElderCare in Manahawkin NJ.  She received her undergrad degree at Rutgers University and her Masters degree at the University of Miami.
What is it? 
The biceps muscle is situated in the front of the upper arm.  The larger section of the biceps, called the long head, is attached to the glenoid fossa of the shoulder by a long tendon.  This tendon passes through a groove in the upper arm known as the bicipital groove.  This is the area, as the groove slides on the tendon, where tendinitis strikes.  In most situations, the injury will cause anterior shoulder pain. 

How does it Happen? 
Very often biceps tendinitis is seen as an overuse-type injury caused by excessive overhead motions (throwing, swimming, spiking, etc.).  In this situation the injury is due to excessive wear on the tendon, but other factors can contribute to the problem.  The biceps tendon is normally held in its groove by the transverse humeral ligament.  If the ligament is injured or stretched the biceps tendon will abnormally slide and cause an irritation.  The bicipital groove itself may be deformed.  If it is too shallow or has rough edges it can also cause an irritation along the tendon. 

Similar Injuries: 
Biceps tendinitis commonly occurs with other shoulder diagnoses.  This is because the subacrominal space - area just below the lateral tip of the shoulder - houses many important structures in a very small area.  The biceps tendon is located in the subacromial space along with the rotator cuff tendons and a bursa sac.  The slightest bit of inflammation will cause an irritation to any or all of these structures. 

Part of the treatment includes controlling the inflammation.  In severe cases a doctor may recommend a cortisone injection or oral anti-inflammatory medication.  Icing the area following strenuous activity, at the end of the day, and more often if able will be very beneficial.  A bag of frozen vegetables will do nicely if  ice or an ice bag is not available.  Strengthening of 
long head of the biceps, rotator cuff, scapular muscles, and shoulder proprioception may be needed. If rehabilitation has been recommended by a doctor, the physical therapist or athletic trainer may choose different modalities such as electrical stimulation, ultrasound, or iontophoresis to address pain relief as well as control inflammatory process.  Time off from the aggravating activity is also usually needed. 

Participation Status: 
If the athlete is only having minor pain with activity they normally can participate as tolerated while beginning ice treatments and rehab.  If the injury progresses to pain during and after activity the athlete can usually participate but requires rehabilitation and days off from the injury causing motion.  The athlete that reaches the stage of pain before, during, and after activity, warrants referral to an orthopedist before regular overhead activities are permitted. 


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