In the biceps tension test, what does anterior shoulder pain suggest?

In the biceps tension test, what does anterior shoulder pain suggest?

• A. Posterior shoulder pain suggests labral tear
• B. Pain with abduction suggests deltoid injury
• C. Anterior shoulder pain suggests biceps tendon involvement
• D. Pain relief indicates instability

Answer: (C)

The biceps tension test stresses the long head of the biceps tendon as it runs in the anterior shoulder. When anterior shoulder pain is elicited during this maneuver, it indicates the tendon is involved—likely tendinopathy, tenosynovitis, or proximal tendon pathology (and relatedly, involvement near the labrum such as a SLAP lesion). The pain location fits the tendon’s path in front of the shoulder, so anterior pain during the test is the best clue pointing to biceps tendon involvement. Pain that appears in other locations or under different maneuvers suggests other structures (for example, posterior pain points toward other posterior structures or labral issues, pain with abduction implicates the deltoid or rotator cuff rather than the biceps tendon, and relief of pain is not used to indicate instability).

The biceps tension test stresses the long head of the biceps tendon as it runs in the anterior shoulder. When anterior shoulder pain is elicited during this maneuver, it indicates the tendon is involved—likely tendinopathy, tenosynovitis, or proximal tendon pathology (and relatedly, involvement near the labrum such as a SLAP lesion). The pain location fits the tendon’s path in front of the shoulder, so anterior pain during the test is the best clue pointing to biceps tendon involvement. Pain that appears in other locations or under different maneuvers suggests other structures (for example, posterior pain points toward other posterior structures or labral issues, pain with abduction implicates the deltoid or rotator cuff rather than the biceps tendon, and relief of pain is not used to indicate instability).