Bicipital Tendinitis

Bicipital Tendinitis

injuries are a common problem in the general population, but these
injuries are particularly common in weight lifting, body building,
tennis, golf and martial arts.

Among the most common injuries is
sprain/strain of the biceps.  This muscle flexes the forearm to the
shoulder.  It is commonly injured through repetitive use, violent
stretch and with acceleration/deceleration of the arm/shoulder unit.

biceps has two heads, as the name would suggest, one entering the
shoulder capsule through the biceps groove and running under the
shoulder blade, the other head attaching on the coronoid process of the
scapulae.Biceps tendinitis- kink ease

of biceps tendinitis reflect the relationship of the biceps tendon to
surrounding structures.  This sometimes makes diagnosis more
challenging, and sometimes it leads to inaccurate diagnosis.

misdiagnosed as ‘rotator cuff tear,’ treatment must be directed at the
site of injury, while maintaining flexibility and health of the joint.Biceps tendon kinkease

is easy to see, from the figure to the right, that the long head of the
biceps run through the bicipital groove.  As it does so, it is very
close to the suscapularis muscle.  Inflammation here, will cause
symptoms in all muscle groups in contact with the injured tendon.   I
will be uploading images that will clarify some of the information
mentioned, above.

Biceps tendon subscapularis kinkease

As the biceps tendon attaches very close to the attachment of the
subscapularis muscle,  resulting symptoms include  pain, spasm and
achiness under the shoulder blade.  This muscle spasm is very difficult
to treat. The shoulder blade lies between the skin and the muscle,
making it difficult to approach directly. It must be treated indirectly, which requires more finesse and time.


consists of oral anti-inflammatory medications, muscle relaxants and
topical anti-inflammatories.  Injection is a last resort, because it
can weaken the tendon, leading to rupture.

Treatment must be focused on the tendons of the shoulder capsule, maintenance of flexibility, and reduction in inflammation.

topical anti-inflammatory of choice may be a combination of
flurbiprofen and ketoprofen in an isopropyl alcohol with NDMS
enhancement. This is a compounded product, available by prescription.

An alternative to prescription medications, one that is available without prescription is ‘kink-ease,’
which is a high potency MSM salve.  In either case, the topical should
be used first thing in the morning, last thing at night and once or
twice during the day.

The Keto/flurbo is a prescription medication, a custom compounded mixture must be ordered by your physician.  It costs about $40 per ounce.

Kink ease is available, without prescription, at a cost of about $4.50 an ounce. It can be found at this web address:


About David S Klein, MD 149 Articles
David S. Klein, MD, FACA, FACPM was born in Washington, DC, and was raised in Chevy Chase, Maryland. He completed his undergraduate education at the University of Maryland with degrees in Chemistry and Psychology. Medical School was completed at the University of Maryland at Baltimore, followed by Internship in General Surgery at the University of North Carolina and Residency in Anesthesiology at the Duke University, Durham, North Carolina. Dr Klein has been practicing medicine since 1983, concentrating in Pain Medicine, Minimally Invasive Medicine and Surgery, and Neuroendocrinology. Earning Board Certification in Anesthesiology, Dr. Klein was elected Fellow in the American College of Anesthesiology, and he was elected Fellow in the American College of Pain Medicine. He is currently an adjunct Associate Professor at the University of Central Florida, School of Medicine. He has focused his private practice on treating patients with hormone imbalance issues, nutritional deficiency related medical problems as well as pain related issues and impairment. With a highly-complex, CLIA licensed laboratory in-house, he has been able to provide rapid-turn around analysis efficiently and cost-effectively. Lecturing extensively nationally as well as internationally, Dr. Klein has authored many articles on topics relating to pain, injury and nutritionally modulated illness. His radio show, “Pain Free Living,” received top ratings during the 6 years it was on the air. Currently practicing in Longwood, Florida, Dr. Klein practices entirely in the office setting.