Long Head of Biceps Proximal Tendon

tendo proximalis capitis longi musculi bicipitis brachii

The proximal long head of biceps tendon originates from the supraglenoid tubercle and superior glenoid labrum, traverses the glenohumeral joint intra-articularly, and enters the bicipital groove at the humeral head. As it descends the groove it is stabilised by the transverse humeral ligament and the biceps pulley. The intra-articular component is enclosed by a synovial sheath continuous with the joint.

Region: Upper Arm

Clinical Relevance

Clinical Notes

At the upper arm level the long head biceps tendon lies in the bicipital groove, where it is accessible for ultrasound assessment with the arm in 10-20 degrees of internal rotation. Subluxation from the groove produces a snapping sensation. Tenodesis anchor placement sits in the proximal bicipital groove, and the tendon remnant above can cause continued pain if not managed. The groove-level tendon differs from its intra-articular portion clinically — groove pathology responds to injection, labral pathology does not.

Pathology

Common Injuries & Conditions

Bicipital Groove Tendinopathy

Degenerative change in the long head biceps tendon within the bicipital groove producing anterior shoulder and upper arm pain reproduced by the Speed and Yergason tests and groove palpation.

Long Head Biceps Subluxation

Medial subluxation of the long head tendon out of the bicipital groove from transverse humeral ligament failure, producing a painful snap with shoulder rotation.