yogabook / pathology / coracobrachialis insertional tendinopathy

Definition of

Insertional tendinopathy of the origin of the coracobrachialis at the coracoid process. There are hardly any sources on this very rare disorder that describe the insertional tendinopathy of the origin of the coracobrachialis independently of the short head of the biceps. This may be due to the fact that this disorder is very rare, but could also be due to the fact that it is usually misdiagnosed as the much more common Bench Presser’s Shoulder, which is localised at the same site, but does not affect the frontal abductor of the glenohumeral joint, but rather the pectoralis minor scapular depressor and protractor. After correct functional testing, however, this confusion cannot occur as the latter behaves completely differently to the frontal abductors.

Cause

1. Overuse with frontal abduction postures and arm movements
2. Technique errors such as bouncing movements in strength training and bounce (reversal)/reversal bounce in the transition from excentric to concentric contraction.

Predisposing

1. Tendon-damaging medication: Fluroquinolones, cortisone (also locally infiltrated)

Diagnosis

1. Functional testing: pain with frontal abduction such as front lifting, but not with low transverse adduction such as bench press; no pain with powerful flexion of the elbow joint or with elevation and depression of the shoulder blade.
2. Ternderness of the coracoid process

Symptoms

1. Pain in the area of the coracoid during frontal abduction in the shoulder joint

Complications

1. Tendon rupture
2. Avulsion

Therapy

1. Change of technique: avoid bounce (reversal), use HSR (heavy slow repetitions) instead
2. Stretching training if necessary

Differential diagnosis

1. Bench Presser’s Shoulder
2. Insertional tendinopathy of the origin of the short tendon of the biceps