Do they have a history of previous or recurrent GH dislocation or have they had shoulder surgery that disrupted the Superior Glenohumeral Ligament?
Studies have shown that fibres from the Superior Glenohumeral Ligament along with Subscapularis contribute to the stability of the intraarticular part of the long head biceps brachii.
We currently have a patent post SLAP surgery. He sought treatment at our office after his long head biceps unexplainably detached from it’s attachment at the supraglenoid tubercle.
Could disruption to the Superior Glenohumeral Ligament and or Subscapularis tissues during surgery be one possible cause?
If you have current patients with intact LHB’s post shoulder surgery, fully assessing the shoulder and determining a course of treatment that focuses on attempting to correct dysfunctional coupling mechanisms, biomechanical deficiencies and mobility and stability dysfunctions seems more appropriate than just addressing biceps hypertonicity alone don’t you think?
the superior glenohumeral ligament is involved in the stabilizing mechanisms of the intraarticular part of the tendon of the long head of the biceps brachii
http://www.ncbi.nlm.nih.gov/pubmed/20434927
The superior glenohumeral ligament ran spirally along the biceps tendon. Histologically, the superior glenohumeral ligament was attached to the tendinous slip. To keep the biceps tendon in place and stabilized, tension in the superior glenohumeral ligament and the buttress support of the most superior insertion point of the subscapularis from behind the ligament may be necessary.
http://www.ncbi.nlm.nih.gov/pubmed/19535271