Clinical Reasoning-Led Physiotherapy Intervention for Biceps Tendinopathy: A Case Report

Area of Science:

• Musculoskeletal physiotherapy
• Clinical reasoning in rehabilitation
• Shoulder tendinopathy management

Background:

• Long head of biceps tendinopathy (LHBT) is a frequent cause of anterior shoulder pain.
• LHBT symptoms often overlap with other shoulder conditions, leading to misdiagnosis.
• Accurate diagnosis is crucial for effective treatment of shoulder pain.

Purpose of the Study:

• To present a case report of a patient with chronic shoulder pain.
• To demonstrate the application of clinical reasoning, guided by the ICF framework, in diagnosing LHBT.
• To evaluate the effectiveness of a structured physiotherapy program for LHBT recovery.

Main Methods:

• A 56-year-old female with chronic shoulder pain was assessed using clinical reasoning and the ICF framework.
• An individualized physiotherapy program spanning 6 weeks included pain management, manual therapy, range of motion, strengthening exercises, and patient education.
• Outcome measures included pain intensity (0-10 scale), muscle strength (MRC scale), and functional disability scores (SPADI, DASH).

Main Results:

• Clinical reasoning confirmed LHBT as the diagnosis.
• Following the 6-week physiotherapy intervention, pain decreased from 7/10 to 1/10.
• Muscle strength improved from 4/5 to 5/5, and SPADI and DASH scores reduced by over 80%.

Conclusions:

• Structured, clinical reasoning-based physiotherapy facilitates accurate diagnosis and effective recovery in LHBT.
• This case highlights the value of evidence-informed, individualized approaches in musculoskeletal rehabilitation.
• The presented model can guide physiotherapy interventions for similar shoulder conditions.