The biceps muscle is found in the front of the upper arm and is attached to the shoulder and lower arm bone by tendons. It helps control lower arm movement and is particularly instrumental in the follow through of forceful throwing movements such as those in football or baseball. When the tendons are overused or overstressed, they become irritated and inflamed. This condition is called Biceps Tendonitis. It is often secondary to rotator cuff instability.

Biceps tendonitis may cause pain along the front of the shoulder during arm and shoulder movement - particularly forward and upward movements. Pain may intensify at night and become increasingly prevalent during daily activity such as lifting or carrying groceries or garbage bags.

Those at Risk
While athletes in throwing sports are often diagnosed with this condition, it can affect any active male or female who repetitively overuses the biceps muscle. A direct trauma or calcification in the tendon may also prompt the condition.

Diagnosis
Following patient history, physical examination and pain analysis, radiographic testing will confirm diagnosis.

Treatment
Biceps tendonitis is generally treated with a conservative nonsurgical program involving anti-inflammatory medication and cold compression. A rehabilitative exercise program designed to strengthen and promote flexibility of the shoulder stabilizers is developed. Depending on the severity of the pain, corticosteroid injections may be indicated in order to reduce the inflammation and pain. And an ongoing rehabilitation program is developed specifically to the patient in order to ensure a safe return to sport with no recurrence.

Radial nerve dysfunction occurs when there is damage to the radial nerve, which travels down the arm. It aids the movement of the triceps muscle located at the back of the arm, as well as facilitates extension at the wrist and sensation in the wrist and hand. Radial nerve dysfunction is generally caused by a direct trauma, long-term pressure on the nerve, or compression resulting from nearby swelling or injury. It is most commonly associated with fractures of the humerus or upper arm bone, but may also result from unusual compression to the underarm, such as using crutches for an extended period of time.

Radial nerve dysfunction is a form of peripheral neuropathy. When a single nerve group such as the radial nerve is damaged it is called a mononeuropathy, which indicates a single, local cause of nerve damage.

Symptoms may include difficulty extending the arm at the elbow, as well as difficulty extending the wrist. There may also be some numbing, reduction in sensation, a burning sensation and pain. Depending on the severity of the case, patients may experience a wrist drop or finger drop, as a result of a weakened muscle.

Those at Risk
Those sustaining trauma to the upper arm and those subjected to crutches for an extended period of time are at risk for this condition.

Diagnosis
Following patient history, and neuromuscular examination of the arm, hand and wrist, diagnosis of radial nerve dysfunction may also involve an electromyogram (EMG) to verify that muscles at the back of the upper arm are working properly. Improper functioning of the muscle is generally caused by a malfunction in the supervising nerve. A nerve conduction velocity (NCV) test may also be used, in order to measure the speed of an electrical impulse as it travels along the radial nerve. A slow speed indicates an entrapped nerve.

Treatment
The first phase of treatment for radial nerve dysfunction in the triceps is conservative and includes refraining from the activity responsible for the condition, as well as those irritating the condition. A lightweight plastic removable arm splint may be indicated at night if pain worsens during sleep. A patient-specific physical or occupational therapy program is established in order to increase the success of the other conservative treatment plans.

When the condition is nonresponsive to conservative treatment and symptoms persist, an outpatient procedure that helps to decompress the nerve may be indicated.

And following all treatment options is a rehabilitation program that demonstrates correct alignment and positions during activity. It also includes active range of motion and stretching exercises - possibly combined with a soft-tissue massage. Isometric exercises following a surgical procedure helps to improve upper arm and hand strength - while placing minimal stress on the tissues near the recovering nerve.