Patients, especially computer users, tend to develop tendinitis of the long head of the biceps that presents as pain in the front of the shoulder. The tendinitis often develops from the tendon slipping back and forth out of the bicipital groove. This is a response to excessive internal and external rotation of the shoulder. Typically, the shoulder is compensating for the inability of the elbow complex to rotate (pronation and supination) but especially internally (pronation).

If you have a patient with anterior shoulder pain that is slow to resolve, make sure to assess the rotation component of elbow movement.