Biceps Brachii Long Head Tendon (Full)

tendo capitis longi musculi bicipitis brachii

The long head of biceps tendon is the most commonly painful biceps component, spending its proximal 10 cm within the glenohumeral joint before entering the bicipital groove. Its intra-articular segment is susceptible to impingement, fraying, and superior labral SLAP tear at its glenoid origin. Biceps tenodesis (fixation to the bicipital groove or subscapularis tendon) eliminates anterior shoulder pain from biceps tendinopathy while preserving elbow flexion and supination strength.

Region: Shoulder

Biomechanics

Function & Actions

Glenohumeral joint depression and head stabilisation (minor); forearm supination; elbow flexion assistance

Clinical Relevance

Clinical Notes

The O'Brien active compression test, Speed's test, and Yergason test assess LHB pathology. Biceps tendinopathy on MRI shows T2 signal within the bicipital groove sheath fluid. Biceps tenotomy (releasing the LHB from the supraglenoid origin) provides immediate pain relief with minimal functional deficit but risks the cosmetic 'Popeye' deformity from muscle belly descent. Tenodesis avoids the Popeye sign and is preferred in active patients under 65.

Pathology

Common Injuries & Conditions

Biceps Tendinopathy and SLAP

LHB intra-articular tendon degeneration and superior labral tear managed with biceps tenodesis preserving elbow function while eliminating the intra-articular biceps segment.