PRP for Biceps Tendonitis / Tendinosis

Sports Medicine | PRP for Biceps Tendon Injury

Biceps tendonitis is the inflammation of the long head of the Biceps tendon. A tendon is a band of connective tissue that attaches muscles to the bones. The biceps muscle is a muscle located in the front part of the upper arm and attaches at the elbow at one end and at two places at the shoulder. Its function is to help move your forearm forwards and backwards. It also helps in stabilizing the head of the upper arm during shoulder motion.

Biceps tendonits is more common among people who engage in frequent pulling, lifting heavy weight, or throwing (for work or recreation purposes) coupled with repetitive overhead activity.

It is primarily seen in men and women between the age of 25 and 40. Sport-related tendonitis is seen in teens to middle-aged adults. It occurs in a variety of sports including weight lifting, tennis, wheelchair athletics (and general wheelchair use), cricket, baseball, and other sports where overhead activity is involved. Complications like degenerative changes in the tendon and rupture are usually seen in older patients.

It occurs equally in male and female athletes.

Biceps Tendonitis Cause

Biceps tendonitis occurs from stress on the arm and shoulder, overuse of the biceps tendon, or from any injury to the biceps tendon. Injury can be a fall or even lifting heavy weights that stresses the tendon. Sometimes, there may be no known cause of this type of tendinitis.

When there is an injury, the tendon may become inflamed due to bone spurs rubbing on the biceps tendon which creates instability of the tendon.

Biceps tendonitis can also occur as a secondary condition. If you have other conditions, such as rotator cuff injuries or labral tears, you may develop a secondary injury because you have to compensate for not being able to use the rotator cuff and labrum. Your doctor will be able to diagnose and explain you the reason for your condition.

Biceps Tendonitis Symptoms

You will notice pain at the front of the shoulder which extends down the biceps muscle. Pain is worse when lifting weights in front of the body and lifting weights over your head. You may feel pain when you move your arm above your shoulder. You may also feel pain as you press on the front of the shoulder. Tenderness and swelling may also be a symptom of this form of tendinitis.

Biceps Tendonitis Diagnosis

Your doctor will ask you about how your pain developed. He will ask you about your occupation and if you have recently lifted something that was heavy. He will thoroughly examine your arm and shoulder to check for swelling and redness. He will press on the area along the biceps muscle and biceps tendons to see if it causes you pain.

An ultrasound scan is useful to help diagnose biceps tendonitis and a rotator cuff tear. Your doctor may also order an MRI to diagnose your condition only after a unsuccessful rehabilitation.

Arthroscopy is not usually necessary, but can be used to determine the cause of chronic shoulder pain.

Biceps Tendonitis Complications

Inflammation may become severe enough to weaken the tendon and lead to a tear of tendon fibers or complete rupture of the tendon, but the fear of rupture or tear is mostly in older patients.

Biceps Tendonitis Treatments

Conservative treatment should be considered for early onset of biceps tendinitis. This includes adequate rest and restricting physical activity. Ice packs can be placed on the shoulder for twenty to thirty minutes every three to four hours for a few days or until pain disappears.

Non steroidal anti-inflammatory drugs (NSAIDs) can be taken with proper consultation from your doctor to relieve pain and swelling.

Your doctor may also give you a steroid injection to relieve inflammation and pain associated with this condition, but steroid injections can potentially cause fat atrophy and depigmentation of the skin over the injection site.

You can also perform rehabilitation exercises at home. Your physiotherapist will be able to teach you some gentle stretching exercises. Stretching exercises increase blood supply to the area, increase physical efficiency and performance, and decrease risk of injury.

You should not be in a hurry to return to sports or activity as this may result in further damage.

In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

Transcutaneous Electrical Nerve Stimulation (TENS) is one treatment option where an electric current is used to stimulate the nerves and help treat painful tendon conditions.

If conservative and medical treatment fails, you can opt for surgery. Generally surgical intervention is not indicated, but if the progress is slow and gradual, then you may have to consider this option.

Arthroscopic surgery is generally performed using fiberoptic instruments, which anchors the tendon to relieve pain produced by shoulder instability.

However, if the tendon ruptures, you will need to consult an orthopaedic surgeon to fix the rupture as soon as possible.

PRP for Biceps Tendonitis / Tendinosis

Platelet Rich Plasma(PRP) therapy has received a great deal of publicity as of late because it has been responsible, in large part, for the recovery of many top athletes from injury. With the likes of Alex Rodriguez and Troy Polamalu publicly vouching for this therapy, not only has more attention been garnered, but studies are also being done in earnest to test the validity and effectiveness of the medical procedure.

Today, individuals with soft tissue injuries are considering PRP therapy in lieu of traditional treatments. It is appropriate for muscles, tendons, and even bone injuries and is especially effective for treating the conditions of tendonitis and tendinosis. Individuals with bicep tendonitis or tendinosis should discuss the procedure with their physician if traditional treatment methods haven’t been effective or if a person is interested in trying a cutting edge therapy rather than a traditional one.

Biceps tendonitis is a condition characterized by the inflammation of the biceps tendon located near the head of the biceps muscle.  Tendinosis is a more severe condition. It is the degeneration of the aforementioned tendon. Both conditions can be caused by overuse and are often experienced by athletes. Biceps tendinosis can also be caused by age.

Tendinitis is often treated conservatively. A person that suffers from these conditions may be instructed to rest their bicep, apply ice, and take anti-inflammatory drugs. They may also be directed to receive physical therapy and/or receive shots of corticosteroid. Overtime, if a person uses these conservative treatment methods, they should eventually see the pain, discomfort and lack of mobility, subside. However, it can take some time. There will be instances when the condition doesn’t get better.

If traditional treatment methods do not work, a person may want to discuss some alternative therapies with their doctor.  PRP has quickly become not only one of the most alternative treatments requested but one of the most effective.

If after three months, traditional therapies have not resulted in the improvement of either condition, additional measures may need to be taken. Surgery is one of the most common though not one of the most desirable. Surgery may or may not be effective and recovery can be painful. One alternative option is PRP therapy. It has been proven to significantly speed up recovery time without being invasive or painful.

PRP therapy uses platelets found in the blood to accelerate healing. Platelets are utilized because of the growth factors they contain.   Growth factors are known to facilitate healing and by injecting a concentrated amount of them into an injured body part, in this case the bicep, healing can be greatly accelerated.

As it stands, most insurance companies will not pay for PRP therapy because it is deemed semi-experimental. Individuals will thus have to pay for the procedure themselves. It generally costs between $500 and $1,500 per injection.

PRP Injection Protocol and Procedures

PRP FAQ- Questions To Ask Your Doctor

  1. Is PRP therapy a viable option for me?
  2. What exactly does PRP entail?
  3. How much experience do you have administering PRP therapy?
  4. How much will the procedure cost?
  5. What happens if PRP therapy doesn’t work for me?

Biceps Tendonitis Prognosis

Modification of physical activity definitely helps to recover from this condition. Individuals with mild-to-moderate cases usually recover faster than those with severe cases. More severe cases have a longer road to recovery.

Biceps Tendonitis Prevention

The best way to prevent biceps tendonitis from occurring is to do proper warm-up and stretching exercises before you start any physical activity. Modification of physical activities (work related or recreation) may be appropriate with guidance from a physiotherapist.

Questions a physician may like to ask you about your condition

  1. How long have you had pain?
  2. What is your occupation?
  3. Do you play sports? If yes, what kind of sports?
  4. How many hours do you play daily?
  5. Do you exercise?
  6. Do you have any other illness along with this?
  7. Have you tried treatment at home for this condition?
  8. Have you tried taking any medicines for this condition?
  9. Did you get any relief from any treatment or medicines?