Review Article| Volume 35, ISSUE 1, P29-45, January 2016

Download started.


Examination of the Biceps Tendon

Published:October 02, 2015DOI:


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.


      Subscribe to Clinics in Sports Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Gerber C.
        • Galantay R.V.
        • Hersche O.
        The pattern of pain produced by irritation of the acromioclavicular joint and the subacromial space.
        J Shoulder Elbow Surg. 1998; 7: 352-355
        • McFarland E.G.
        • Hobbs W.R.
        The active shoulder: AC joint pain and injury.
        Your Patient and Fitness. 1998; 12: 23-27
        • Murthi A.M.
        • Vosburgh C.L.
        • Neviaser T.J.
        The incidence of pathologic changes of the long head of the biceps tendon.
        J Shoulder Elbow Surg. 2000; 9: 382-385
        • Chen C.H.
        • Hsu K.Y.
        • Chen W.J.
        • et al.
        Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears.
        J Trauma. 2005; 58: 1189-1193
        • Taylor S.A.
        • Khair M.M.
        • Gulotta L.V.
        • et al.
        Diagnostic glenohumeral arthroscopy fails to fully evaluate the biceps-labral complex.
        Arthroscopy. 2015; 31: 215-224
        • Moon S.C.
        • Cho N.S.
        • Rhee Y.G.
        Analysis of “hidden lesions” of the extra-articular biceps after subpectoral biceps tenodesis: the subpectoral portion as the optimal tenodesis site.
        Am J Sports Med. 2015; 43: 63-68
        • Hitchcock H.H.
        • Bechtol C.O.
        Painful shoulder: observations of the role of the tendon of the long head of the biceps brachii in its causation.
        J Bone Joint Surg Am. 1948; 30: 263-273
        • Meyer A.W.
        Spontaneous dislocation of the tendon of the long head of the biceps brachii.
        Arch Surg. 1926; 13: 109-119
        • Walch G.
        • Nove-Josserand L.
        • Boileau P.
        • et al.
        Subluxations and dislocations of the tendon of the long head of the biceps.
        J Shoulder Elbow Surg. 1998; 7: 100-108
        • Braun S.
        • Horan M.P.
        • Elser F.
        • et al.
        Lesions of the biceps pulley.
        Am J Sports Med. 2011; 39: 790-795
        • Khazzam M.
        • George M.S.
        • Churchill R.S.
        • et al.
        Disorders of the long head of biceps tendon.
        J Shoulder Elbow Surg. 2012; 21: 136-145
        • Meyer A.W.
        Spontaneous dislocation and destruction of long head of biceps brachii. Fifty-nine instances.
        Arch Surg. 1928; 17: 493-506
        • Chang D.
        • Mohana-Borges A.
        • Borso M.
        • et al.
        SLAP lesions: anatomy, clinical presentation, MR imaging diagnosis and characterization.
        Eur J Radiol. 2008; 68: 72-87
        • Morgan C.D.
        • Burkhart S.S.
        • Palmeri M.
        • et al.
        Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears.
        Arthroscopy. 1998; 14: 553-565
        • Burkhart S.S.
        • Morgan C.D.
        • Kibler W.B.
        The disabled throwing shoulder: spectrum of pathology. Part I: pathoanatomy and biomechanics.
        Arthroscopy. 2003; 19: 404-420
        • Kim T.K.
        • Queale W.S.
        • Cosgarea A.J.
        • et al.
        Clinical features of the different types of SLAP lesions. An analysis of one hundred and thirty-nine cases.
        J Bone Joint Surg Am. 2003; 85: 66-71
        • Gerber C.
        • Krushell R.J.
        Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases.
        J Bone Joint Surg Br. 1991; 73: 389-394
        • Hertel R.
        • Ballmer F.T.
        • Lambert S.M.
        • et al.
        Lag signs in the diagnosis of rotator cuff rupture.
        J Shoulder Elbow Surg. 1996; 5: 307-313
        • Barth J.R.
        • Burkhart S.S.
        • De Beer J.F.
        The bear-hug test: a new and sensitive test for diagnosing a subscapularis tear.
        Arthroscopy. 2006; 22: 1076-1084
        • Eakin C.L.
        • Faber K.J.
        • Hawkins R.J.
        • et al.
        Biceps tendon disorders in athletes.
        J Am Acad Orthop Surg. 1999; 7: 300-310
        • Tantisricharoenkul G.
        • Tan E.W.
        • Fayad L.M.
        • et al.
        Malignant soft tissue tumors of the biceps muscle mistaken for proximal biceps tendon rupture.
        Orthopedics. 2012; 35 (898): e1548-e1552
        • Ludington N.A.
        Rupture of the long head of the biceps flexor cubiti muscle.
        Ann Surg. 1923; 77: 358-363
        • Brasseur J.L.
        The biceps tendons: from the top and from the bottom.
        J Ultrasound. 2012; 15: 29-38
        • Matsen III, F.A.
        • Kirby R.M.
        Office evaluation and management of shoulder pain.
        Orthop Clin North Am. 1982; 13: 453-475
        • McFarland E.G.
        Examination of the biceps tendon and superior labrum anterior and posterior (SLAP) lesions.
        in: Kim T.K. Park H.B. El Rassi G. Examination of the shoulder: the complete guide. Thieme, New York2006: 213-243
        • Crenshaw A.H.
        • Kilgore W.E.
        Surgical treatment of bicipital tenosynovitis.
        J Bone Joint Surg Am. 1966; 48: 1496-1502
        • O'Brien S.J.
        • Newman A.M.
        • Taylor S.
        • et al.
        The accurate diagnosis of biceps-labral complex lesions with MRI and “3-pack” physical examination: a retrospective analysis with prospective validation.
        Orthop J Sports Med. 2013; 1
        • Gill H.S.
        • El Rassi G.
        • Bahk M.S.
        • et al.
        Physical examination for partial tears of the biceps tendon.
        Am J Sports Med. 2007; 35: 1334-1340
        • Abbot L.C.
        • Saunders J.B.
        Acute traumatic dislocation of the tendon of long head of biceps brachii. A report of six cases with operative findings.
        Surgery. 1939; 6: 817-840
        • Yergason R.M.
        Supination sign.
        J Bone Joint Surg Am. 1931; 13: 160
        • Holtby R.
        • Razmjou H.
        Accuracy of the Speed's and Yergason's tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings.
        Arthroscopy. 2004; 20: 231-236
        • Parentis M.A.
        • Glousman R.E.
        • Mohr K.S.
        • et al.
        An evaluation of the provocative tests for superior labral anterior posterior lesions.
        Am J Sports Med. 2006; 34: 265-268
        • Oh J.H.
        • Kim J.Y.
        • Kim W.S.
        • et al.
        The evaluation of various physical examinations for the diagnosis of type II superior labrum anterior and posterior lesion.
        Am J Sports Med. 2008; 36: 353-359
        • Boileau P.
        • Ahrens P.M.
        • Hatzidakis A.M.
        Entrapment of the long head of the biceps tendon: the hourglass biceps – a cause of pain and locking of the shoulder.
        J Shoulder Elbow Surg. 2004; 13: 249-257
        • Gobezie R.
        • Zurakowski D.
        • Lavery K.
        • et al.
        Analysis of interobserver and intraobserver variability in the diagnosis and treatment of SLAP tears using the Snyder classification.
        Am J Sports Med. 2008; 36: 1373-1379
        • Jia X.
        • Yokota A.
        • McCarty E.C.
        • et al.
        Reproducibility and reliability of the Snyder classification of superior labral anterior posterior lesions among shoulder surgeons.
        Am J Sports Med. 2011; 39: 986-991
        • Mimori K.
        • Muneta T.
        • Nakagawa T.
        • et al.
        A new pain provocation test for superior labral tears of the shoulder.
        Am J Sports Med. 1999; 27: 137-142
        • O'Brien S.J.
        • Pagnani M.J.
        • Fealy S.
        • et al.
        The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality.
        Am J Sports Med. 1998; 26: 610-613
        • Stetson W.B.
        • Templin K.
        The crank test, the O'Brien test, and routine magnetic resonance imaging scans in the diagnosis of labral tears.
        Am J Sports Med. 2002; 30: 806-809
        • Berg E.E.
        • Ciullo J.V.
        A clinical test for superior glenoid labral or 'SLAP' lesions.
        Clin J Sport Med. 1998; 8: 121-123
        • Walsworth M.K.
        • Doukas W.C.
        • Murphy K.P.
        • et al.
        Reliability and diagnostic accuracy of history and physical examination for diagnosing glenoid labral tears.
        Am J Sports Med. 2008; 36: 162-168
        • Cook C.
        • Beaty S.
        • Kissenberth M.J.
        • et al.
        Diagnostic accuracy of five orthopedic clinical tests for diagnosis of superior labrum anterior posterior (SLAP) lesions.
        J Shoulder Elbow Surg. 2012; 21: 13-22
        • Hegedus E.J.
        • Goode A.P.
        • Cook C.E.
        • et al.
        Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests.
        Br J Sports Med. 2012; 46: 964-978
        • McFarland E.G.
        • Kim T.K.
        • Savino R.M.
        Clinical assessment of three common tests for superior labral anterior-posterior lesions.
        Am J Sports Med. 2002; 30: 810-815
        • Meserve B.B.
        • Cleland J.A.
        • Boucher T.R.
        A meta-analysis examining clinical test utility for assessing superior labral anterior posterior lesions.
        Am J Sports Med. 2009; 37: 2252-2258
      1. Cheung EV, O'Driscoll SW. The dynamic labral shear test for superior labral anterior posterior tears of the shoulder. Podium presentation at the 76th Annual Meeting of the American Academy of Orthopaedic Surgeons. San Diego (CA), February 14–17, 2007.

        • Ben Kibler W.
        • Sciascia A.D.
        • Hester P.
        • et al.
        Clinical utility of traditional and new tests in the diagnosis of biceps tendon injuries and superior labrum anterior and posterior lesions in the shoulder.
        Am J Sports Med. 2009; 37: 1840-1847
      2. Sodha S, Joseph J, Borade A, et al. Clinical assessment of the dynamic shear test for SLAP lesions. Presented at The American College of Sports Medicine 62nd Annual Meeting. San Diego (CA), May 26–30, 2015.

        • Chronopoulos E.
        • Kim T.K.
        • Park H.B.
        • et al.
        Diagnostic value of physical tests for isolated chronic acromioclavicular lesions.
        Am J Sports Med. 2004; 32: 655-661
        • Guanche C.A.
        • Jones D.C.
        Clinical testing for tears of the glenoid labrum.
        Arthroscopy. 2003; 19: 517-523
        • Bennett W.F.
        Specificity of the Speed's test: arthroscopic technique for evaluating the biceps tendon at the level of the bicipital groove.
        Arthroscopy. 1998; 14: 789-796
        • Holtby R.
        • Razmjou H.
        Impact of work-related compensation claims on surgical outcome of patients with rotator cuff related pathologies: a matched case-control study.
        J Shoulder Elbow Surg. 2010; 19: 452-460
      3. Sodha S, Joseph J, Borade A, et al. Clinical assessment of the dynamic shear test for SLAP lesions. Presented at The American Orthopaedic Society for Sports Medicine (AOSSM) annual meeting. Orlando (FL), July 9–12, 2015.

        • Nakagawa S.
        • Yoneda M.
        • Hayashida K.
        • et al.
        Forced shoulder abduction and elbow flexion test: a new simple clinical test to detect superior labral injury in the throwing shoulder.
        Arthroscopy. 2005; 21: 1290-1295
        • Parentis M.A.
        • Mohr K.J.
        • Elattrache N.S.
        Disorders of the superior labrum: review and treatment guidelines.
        Clin Orthop Relat Res. 2002; : 77-87