View Full Version : Subluxation of the bicep tendon

Roger Harrell
06-27-2005, 03:33 PM
I've got a lot of info already, but wanted to throw this out to the Crossfit community to see if anyone has direct experience with this.

I have a condition in my shoulder where the bicep tendon subluxes out of it's groove in the humerus and slips forward. This is quite painful. My shoulders are prone to this and I dealt with it in college with cortizone followed by PT (doc thought it was an impingement, he was wrong, but treatment was correct). Hasn't bugged me in 10 years. Recently it's started occuring again. I've been doing the PT (rotator cuff exercises and such) consistantly and now I'm being even more careful about certain movements until I can get it stabilized. It only bugs me on certain movements. Any pulls where my arm is rotated outward. (el grip giants are out of the question). Swings on rings right now aren't working. Anyway, any thoughts. I know for sure what it is this time cause I did an MRI. Orto wasn't entirely sure what best course of action was. Didn't think any of the surgical solutions would work for me. Basically they haven't run into many 180 lb 33 year old gymnasts...

Matt Gagliardi
06-27-2005, 05:35 PM
You might give this a whirl. I'm familiar with their products because many swimmer and water polo players develop various forms of tendonitis from overuse. IIRC, this strap is designed to help keep the biceps tendon in the groove via compression.
https://secure.cho-pat.com/products/product.php?product_type=6 (http://www.cho-pat.com/products/product.php?product_type=6)

Paul Siatczynski
06-27-2005, 06:04 PM
If the long head of the biceps is truly subluxed on an MRI, then you have either torn part of subscapularis, or the coracohumeral ligament. These will not typically heal with time. You can try a strap to hold it in place, but there's a lot of tissue between the brace and the tendon, and I'd be skeptical that this would work to your satisfaction. Most commonly this would be treated with a surgical procedure called a biceps tenodesis, which would involve anchoring the biceps tendon in the groove. It can be performed either arthroscopically or open, but would take several weeks of recovery time. This is assuming the biceps tendon is seen to be out of the bicipital groove on the MRI. You should be able to go back to gymnastics after a sufficient recovery time. Somebody else might have a better non surgical idea, but I'm not overly optimistic. Good luck.

Roger Harrell
06-27-2005, 11:27 PM
The tendon is not subluxed at rest. It only subluxes under certain conditions. Under pretty heavy loads with my palms turned outward is when it's worst. The MRI shows some wear on the tendon where it subluxes, but no connective tissue separation. There's a little fluid indicating the trauma. Biceps tenodesis was discussed as an option but the ortho did not think it the best option for my case. I'm skeptical about full recovery with tenodess. Removing the leverage of the full length of that tendon with some of the requirements of gymnastics could be a problem. At this point it does not bother me enough to cut into it. There's only a few things I can't do at all, and I may be able to recover it sufficiently. There's no turning back from the surgury.

Paul Siatczynski
06-28-2005, 10:24 AM
Surgery should definitely be your last resort, and it's good that you can still function at a high level. However, the long head of the biceps tendon doesn't seem to have a siginificant function in shoulder mechanics- it's sort of like the appendix of the shoulder. I personally , though, would like to keep as many of my own parts as possible.