## Overview Biceps tendon strain (bicipital tendinitis or tenosynovitis) involves the tendon of the biceps brachii muscle as it runs through the bicipital groove of the humerus and its associated bursa. The tendon stabilizes the shoulder and helps flex the elbow and advance the limb. Injury produces a characteristic shortened cranial phase of the stride and forelimb lameness that can be difficult to localize. ## Causes Repetitive overload from work that loads the forehand, poor foot balance, or compensatory stress from lower-limb or neck problems are common. Acute trauma from forceful backward extension of the limb can also tear the tendon. Conformation and fatigue contribute. ## Diagnosis Shortened stride, reluctance to extend the shoulder, and pain on palpation or flexion of the shoulder are suggestive. Diagnostic analgesia of the bicipital bursa or tendon sheath often improves the lameness. Ultrasound evaluates tendon fiber pattern and bursal effusion; radiographs rule out associated bone injury. ## Treatment Rest, anti-inflammatory medication, and controlled exercise form the core of management. Intrabursal medication may help aseptic inflammation. Severe tears or concurrent septic bursitis may require bursoscopy or more aggressive intervention. ## Recovery and Prognosis Mild cases often return to work in one to three months. More severe tendinopathy can require longer rehabilitation and carries a guarded prognosis for high-level athletic use. Recurrence is possible if underlying biomechanical issues are not addressed. ## Prevention Balanced shoeing, progressive conditioning, and attention to saddle fit and rider balance reduce chronic overload.
forelimb lameness with shortened cranial stride; pain on shoulder flexion or palpation; reluctance to extend the limb fully; occasional swelling at the point of the shoulder
## Overview Biceps tendon strain (bicipital tendinitis or tenosynovitis) involves the tendon of the biceps brachii muscle as it runs through the bicipital groove of the humerus and its associated bursa. The tendon stabilizes the shoulder and helps flex the elbow and advance the limb. Injury produces a characteristic shortened cranial phase of the stride and forelimb lameness that can be difficult to localize. ## Causes Repetitive overload from work that loads the forehand, poor foot balance, or compensatory stress from lower-limb or neck problems are common. Acute trauma from forceful backward extension of the limb can also tear the tendon. Conformation and fatigue contribute. ## Diagnosis Shortened stride, reluctance to extend the shoulder, and pain on palpation or flexion of the shoulder are suggestive. Diagnostic analgesia of the bicipital bursa or tendon sheath often improves the lameness. Ultrasound evaluates tendon fiber pattern and bursal effusion; radiographs rule out associated bone injury. ## Treatment Rest, anti-inflammatory medication, and controlled exercise form the core of management. Intrabursal medication may help aseptic inflammation. Severe tears or concurrent septic bursitis may require bursoscopy or more aggressive intervention. ## Recovery and Prognosis Mild cases often return to work in one to three months. More severe tendinopathy can require longer rehabilitation and carries a guarded prognosis for high-level athletic use. Recurrence is possible if underlying biomechanical issues are not addressed. ## Prevention Balanced shoeing, progressive conditioning, and attention to saddle fit and rider balance reduce chronic overload.
forelimb lameness with shortened cranial stride; pain on shoulder flexion or palpation; reluctance to extend the limb fully; occasional swelling at the point of the shoulder