Mechanical properties of the long head of the biceps tendon

Abstract
In this study, the geometric and mechanical properties of the long head of the biceps tendon were determined in order to elucidate its role in shoulder stability. We used a laser-micrometer system to measure the cross-sectional area and shape of seven fresh-frozen tendons at three levels: proximal, middle, and distal levels. The cross-sectional areas were found to be 22.7±9.3 mm2, 22.7±3.5 mm2, and 10.8±2.7 mm2, respectively. While statistically significant differences could not be demonstrated between the magnitudes of the areas, a consistent difference in shape was noted between the proximal and middle levels, the tendon being flatter as it progressed over the humeral head and more triangular as it passed through the bicipital groove. We then performed cyclic relaxation tests and uniaxial tensile testing of the tendons which revealed a cyclic stress relaxation of 18±4% over ten cycles. All tensile failures occurred within the midportion of the tendon substance. Additionally, the modulus was calculated between 3% and 6% strain and found to be 421±212 MPa, while the ultimate tensile strength, ultimate strain, and strain energy density were 32.5±5.3 MPa, 10.1±2.7%, and 1.9±0.4 MPa, respectively. These mechanical properties of the long head of the biceps tendon are of the same order of magnitude as tendons from other joints. The high stiffness of this tendon indicates that it has an ability to support the large load transferred to it by the muscle and to act as a humeral head depressor.