During the biceps tension test, the presence of anterior shoulder pain suggests involvement of which structure?

During the biceps tension test, the presence of anterior shoulder pain suggests involvement of which structure?

• A. Labrum
• B. Rotator cuff
• C. AC joint
• D. Biceps tendon

Answer: (D)

The test stresses the long head of the biceps tendon as it runs through the front of the shoulder. When that tendon is irritated or inflamed, loading and tensioning it will reproduce pain in the front of the shoulder. So, seeing anterior shoulder pain during this maneuver points to biceps tendon involvement (tendinopathy, tenosynovitis, or a partial tear). In contrast, pathology of other structures tends to present with different pain patterns: rotator cuff problems typically cause lateral or shoulder edge pain with weakness, AC joint issues produce pain at the top of the shoulder near the joint itself, and labral problems often produce deep joint-line pain or mechanical symptoms rather than isolated anterior tendon pain.

The test stresses the long head of the biceps tendon as it runs through the front of the shoulder. When that tendon is irritated or inflamed, loading and tensioning it will reproduce pain in the front of the shoulder. So, seeing anterior shoulder pain during this maneuver points to biceps tendon involvement (tendinopathy, tenosynovitis, or a partial tear). In contrast, pathology of other structures tends to present with different pain patterns: rotator cuff problems typically cause lateral or shoulder edge pain with weakness, AC joint issues produce pain at the top of the shoulder near the joint itself, and labral problems often produce deep joint-line pain or mechanical symptoms rather than isolated anterior tendon pain.