Sports Medicine: Biceps Tendonitis and Tenosynovitis (Distal)
Distal biceps tendonitis is pain at the front of the elbow and upper arm caused by inflammation (swelling) of the biceps tendon. Tenosynovitis (ten-oh-sine-oh-VIE-tis) is inflammation of the tendon sheath (lining) that surrounds the biceps tendon. The lining produces a fluid that greases the tendon. When the lining becomes inflamed, the tendon cannot glide smoothly in its covering (sheath). The biceps tendon is one of the anchor points of the biceps muscle, which is important for bending the elbow and rotating the forearm. It also plays a role in shoulder function.
Signs and Symptoms
- pain, tenderness, swelling, warmth, or redness over the front of the elbow
- a crackling sound when the elbow is moved or touched
- pain that gets worse with elbow motion, repetitive overhead activities, or bending the elbow against resistance
- limited motion of the elbow
Increased Risk
- throwing sports (baseball, softball) and sports that cause repetitive stress to the elbow (gymnastics, weightlifting)
- poor warm-up before practice or play
- poor physical conditioning (strength and flexibility)
Treatment
- Medicine
- Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
- Other minor pain relievers, such as acetaminophen (Tylenol®).
- Use of cold and heat
- Cold should be applied for 10 to 15 minutes every 2 to 3 hours for swelling and after any activity that makes symptoms worse. Use ice packs or an ice massage.
- Heat may be used before performing stretching and strengthening activities prescribed by your health care provider or athletic trainer. Use a heat pack or warm soak. Apply for 10 to 15 minutes.
- Exercises
- Exercises to improve strength, flexibility and proper body mechanics are important. These can be done at home, but often a referral to a physical therapist or athletic trainer may be advised by your health care provider.
- Injection
- Injection of a steroid can sometimes be used to decrease inflammation around the tendon.
- Surgery
- In severe cases, surgery may be necessary to correct the problem if other treatments do not work.
How to Prevent
- Do correct warm-up and stretching before practice or competition.
- Allow time for proper rest and recovery between practices and competition.
- Maintain proper shoulder and elbow flexibility, conditioning, strength, endurance, and cardiovascular fitness.
When to Call the Health Care Provider
Call your health care provider or the Sports Medicine team at (614) 355-6000 if:
- symptoms get worse after 2 weeks, even with treatment
- new, unexplained symptoms develop
Sports Medicine: Biceps Tendonitis and Tenosynovitis (Distal) (PDF)
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