The long head has the longest course of any upper arm tendon, traversing the glenohumeral joint intra-articularly before entering the bicipital groove. This anatomy makes it vulnerable to both proximal (SLAP, tendinopathy) and distal (groove exit rupture) pathology.
| Origin | Supraglenoid tubercle and superior glenoid labrum (intra-articular) |
|---|---|
| Insertion | Radial tuberosity and bicipital aponeurosis |
| Nerve Supply | Musculocutaneous nerve (C5, C6) |
| Blood Supply | Brachial artery |
| Actions | Flexes the elbow; Supinates the forearm — most powerful supinator; Weakly flexes the shoulder |
|---|
Proximal rupture produces the Popeye deformity from distal muscle belly bunching. Surgical repair is elective for cosmesis and supination strength. Distal biceps rupture causes 30% supination loss and is repaired urgently using the endobutton or suture anchor technique.
Palpable throughout the anterior arm — the long head forms the lateral biceps groove.
Spontaneous rupture at the bicipital groove producing the Popeye sign, treated conservatively in elderly patients or by tenodesis in active individuals.
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