One of the more common complaints we hear from patients is that they are experiencing an uncomfortable sensation in their shoulder area. They usually describe it as a clicking or snapping sound that may be accompanied by a catching or popping sensation. While these symptoms could be caused by a few different issues, the most common cause tends to be a problem known as biceps instability. Below, we take a closer look at biceps instability and how it relates to your shoulder discomfort.
Understanding Biceps Instability
When patients mention these symptoms and we note that it could be due to biceps instability, it’s not uncommon to see a look of confusion on their face. Their discomfort is located in their shoulder, and not in the muscle area that we typically associate with an exercise like a biceps curl. Since the discomfort is much higher in their arm, they usually assume that biceps instability isn’t the root cause of their pain.
However, in this instance, biceps instability refers to the biceps tendon, not the biceps muscle. The biceps tendon attaches to your scapula, and the sensation or symptoms you’re experiencing may be occurring when the tendon slips out of the bicipital groove where it normally rests. If your biceps tendon frequently shifts out of this groove, it’s known as biceps instability.
Biceps instability can develop following trauma to the shoulder area or due to a combination of repetitive stress and underlying shoulder development and genetics. You’re more likely to experience symptoms associated with biceps instability when you’re performing reaching actions, like when you reach your arms and shoulders backwards to put on a coat or when buckling your seatbelt in the car. Unless you take steps to help address this instability, the condition is only likely to worsen, which means it will take less stress for the tendon to shift out of its groove.
Treating Biceps Instability
If you are diagnosed with biceps instability, your doctor will likely begin with a course of conservative treatment. This typically involves a careful combination of rest, activity avoidance, anti-inflammatory medications and targeted physical therapy exercises. In some instances, a corticosteroid injection may also be administered in the area so that pain can be better managed and it is easier to follow through on your physical therapy exercises. Many people find that these treatments prove effective when pursued for 6-8 weeks or as recommended by your shoulder specialist.
If weeks of conservative care fail to provide relief, your specialist may recommend a biceps tenodesis procedure. This operation involves removing a portion of the unstable tendon and affixing the biceps tendon to the humerus arm bone. The procedure can be performed in about 10 minutes, and patients may only need a protective sling for 3-5 days after the operation. Physical therapy exercises begin once the sling is removed, and many patients are able to raise their arm above their head within four weeks, although total physical recovery can take up to three months.
If you have been bothered by a painful clicking or catching sensation in your shoulder, take action now while the issue is more treatable, otherwise a surgical procedure may be in your future. For more information about biceps tendonitis, or for help with a different shoulder issue, reach out to Dr. Holloway and his team today at (865) 410-7887.
