Bicipital tendonopathy is a lesion such as fraying or tearing of the long head of the biceps, which causes pain in front of the shoulder. Important signs include pain on resisted flexion of the elbow joint and on resisted supination with the elbow flexed to 90° (Speed test) and forearm

pronated (Yergason test). A painful arc may be present when the intrascapular part is affected. Hence it is often confused with one of the rotator cuff lesions. Sometimes it is possible to elicit local tenderness by palpation along the course of the tendon in the bicipital groove. This is best done when the arm is externally rotated. Most active shoulder movements, especially external rotation, bring on the pain. Bicipital tendonopathy usually follows chronic repetitive strains in young to middle-aged adults (e.g. home decorating, weight training, tennis, swimming freestyle, cricket bowling and baseball pitching). Two complications are complete rupture and subluxation of the tendon out of its groove. One treatment to consider is a corticosteroid and local anaesthetic injection at the site of maximal tenderness in the bicipital groove