Accuracy of long head of the biceps tendon palpation by physical therapists; an ultrasonographic study.
Amy W McDevitt, Joshua A Cleland, Colin Strickland and 5 others
PMID 33281293WHAT IT FOUND
Physical therapists accurately located the biceps tendon in less than half of palpations.
Neither tested shoulder position improved accuracy. Most misses occurred medially. Do not rely on palpation alone to confirm biceps pathology or guide injections.
Key findings
01The overall accuracy of physical therapists palpating the long head of the biceps tendon was 45.7%.
02There was no significant difference in accuracy between the two shoulder positions tested.
03Inter-rater reliability between therapists was poor.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study participants were young (mean age 24.3 years), healthy, and had a low BMI. Accuracy may differ in older patients, those with higher BMI, or those with actual shoulder pathology. The therapists did not receive specific training on the palpation positions, reflecting typical clinical practice but potentially limiting accuracy compared to trained specialists. Ultrasound measurement of the intertubercular groove borders can be variable, particularly on the medial side, which may introduce measurement error. The study used a single ultrasound image per palpation, whereas multiple images might provide more reliable measurements.
Declared interests
The authors declared no financial affiliations or conflicts of interest.
The easy way to misread this
Do not assume that experienced therapists can reliably locate the LHBT by touch. The study found poor inter-rater reliability and an accuracy rate below 50% in healthy individuals. This does not mean palpation is useless for finding tenderness, but it is not a precise method for anatomical localization.