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Dr Jonas Fernandez is an Orthopaedic Surgeon at Putrajaya Hospital. He is also a member of the Malaysian Arthroscopy Society( MAS). |
YOUR biceps might be best known as the muscle you flex in the mirror, but there’ s more going on under the surface than most people realise- especially when it comes to the“ long head” of the biceps tendon. Don’ t worry, this isn’ t going to turn into a dry anatomy lecture. Think of this as a quick, friendly guide to what can go wrong, why it happens, and what it feels like when it does.
First, what is the long head of the biceps? The biceps muscle actually has two“ heads”( hence the name): a short head and a long head. The long head is the more dramatic one: it runs from your upper arm, travels through the shoulder joint, and attaches deep within the shoulder joint.
Because it crosses the shoulder, it’ s involved in both elbow bending and shoulder movement. That double-duty role makes it useful, but also a bit of a troublemaker.
COMMON PROBLEMS
Why your shoulder may be grumbling:
1. Tendinitis( or tendinopathy): This is the most common issue. Essentially, the tendon gets irritated from overuse: think repeated lifting, throwing, or even too much enthusiastic gym work. Instead of a sudden injury, this builds up over time.
What it feels like: A dull, aching pain at the front of your shoulder. It might get worse when you lift your arm or carry things. Some people describe it as a“ nagging” discomfort
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that just won’ t quit.
2. Instability( the wandering tendon): The long head tendon sits in a groove at the top of your arm bone. Sometimes, it slips out of that groove- like a train jumping its tracks. This can happen after injury or due to wear and tear.
What it feels like: A clicking or snapping sensation in the shoulder. It can feel unstable, like something’ s moving that shouldn’ t be. 3. Tears( partial or complete): Yes, the tendon can actually tear. A partial tear means it’ s damaged but still attached; a complete tear means it snaps off entirely. This can happen from sudden strain or long-term degeneration.
What it looks / feels like: Sudden pain, sometimes followed by bruising. If it fully tears, you might notice a funny-looking bulge in your upper arm, often called a“ Popeye muscle.” Oddly enough, pain may actually decrease after a full tear, but strength can be affected. 4. SLAP lesions( fancy name, annoying problem): This pathology was covered in one of my previous articles. It involves the area where the tendon attaches to the inside of the shoulder.“ SLAP” stands for“ Superior Labrum Anterior to Posterior”, but you don’ t need to memorise that. Just know it’ s a type of joint tear.
What it feels like: Deep shoulder pain,
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especially with overhead movements. Athletes who throw( like badminton players) are particularly prone to this.
WHY THIS HAPPENS?
In short: life. The long head of the biceps is constantly in use, and over time, wear and tear add up. Add in sports, gym workouts, poor posture, or sudden injuries, and the tendon can get overwhelmed. Age also plays a role; the older we get, the less resilient our tendons become.
WHAT CAN YOU DO
The good news is that most of these issues don’ t require surgery right away. Rest and activity modification: Sometimes the simplest fix is just giving the tendon a break. Ice and anti-inflammatory measures: Helpful for calming things down. Physiotherapy: Strengthening the surrounding muscles can take pressure off the tendon. Injections or surgery: Reserved for more stubborn or severe cases.
THE TAKEAWAY
The long head of your biceps is a bit like an overworked multitasker. If you notice persistent shoulder pain, clicking, or weakness, it’ s worth getting checked out early before things escalate.- The HEALTH
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