RESUMO
BACKGROUND: Shoulder pain related to pathology of the long head of the biceps tendon (LHBT) can be debilitating. Chronic LHBT tendinopathy is a common condition that is difficult to treat. Little consensus exists regarding the optimal approach to treating individuals with LHBT tendinopathy. OBJECTIVE: To systematically scope the literature to identify and present the available information regarding physical therapist interventions used for the management of individuals with LHBT tendinopathy including types of interventions used or recommended. METHODS: A scoping review of physical therapist interventions used to treat LHBT was conducted of the CINAHL, Embase, Medline, and SportDiscus databases. Full text records reporting physical therapist-based interventions in individuals with proximal LHBT pathology were included. Articles not written in English were excluded. RESULTS: Of the 4059 records identified, 14 articles met the inclusion criteria. Interventions used to treat LHBT tendinopathy identified in quantitative studies included: extracorporeal shock wave therapy, polarized light, ultrasound, low-level laser, iontophoresis, general exercise, eccentric training, stretching, dry needling, and joint mobilization. Interventions described in literature reviews, clinical commentaries, and a Delphi study included: therapeutic modalities, manual therapy, exercise, dry needling, and patient education. CONCLUSION: This scoping review reported interventions primarily based on therapeutic modalities in quantitative studies while literature reviews, clinical commentaries, and a Delphi study described the addition of manual therapy, patient education, exercise, and dry needling. Overall, there is a dearth of evidence detailing the conservative management of LHBT tendinopathy.
Assuntos
Músculo Esquelético , Tendinopatia , Humanos , Modalidades de Fisioterapia , Tendões , Dor de Ombro/terapia , Tendinopatia/terapiaRESUMO
La tendinopatía de la porción larga del Bíceps es causa frecuente de dolor en el hombro. Usualmente esta patología se relaciona con tendinopatía y lesiones del manguito rotador comprometiendo con mayor frecuencia el tendón del subescapular. El diagnóstico de esta entidad es difícil tanto clínica como radiológicamente, y la precisión diagnóstica de las lesiones parciales del Bíceps en Resonancia Nuclear Magnética (RMN) es relativamente baja. El objetivo de la nota técnica es presentar una Tenodesis intra-articular de la porción larga del Bíceps utilizando un anclaje óseo sin nudos, el cual sirve a su vez para reinsertar lesiones de tendón subescapular Laffosse tipo I y II con suturas adicionales.
Long head biceps tendinopathy is a common cause of shoulder pain. Usually, this pathology is related to both, tendinopathy and rotator cuff injuries, most frequently involving the subscapularis tendon. The diagnosis of this entity is difficult clinically and radiologically, and the diagnostic sensitivity and specificity of partial biceps injuries in Magnetic Resonance imaging (MRI) is relatively low. The aim of the technical note is to present an intra-articular tenodesis of the long head of the biceps using a knotless bone anchor, which serves once to reinsert type I and II Laffosse subscapular tendon injuries with additional sutures.