Biceps Tendinitis

The biceps muscle helps with bending the elbow and rotating the forearm, but it also plays an important role in shoulder function. The long head of the biceps tendon travels through the front of the shoulder joint before attaching to the top of the socket (glenoid).

When this tendon becomes irritated or inflamed, it’s called biceps tendinitis — a common source of pain in the front of the shoulder.

What is Biceps Tendinitis?

The biceps muscle has two tendons at the shoulder:

• Long head of the biceps tendon: Runs inside the shoulder joint and attaches to the top of the socket (labrum).

• Short head of the biceps tendon: Attaches to the coracoid process, outside the joint.

Biceps tendinitis refers to inflammation of the long head of the biceps tendon, often caused by overuse, repetitive overhead motions, or degeneration over time.

What Causes Biceps Tendinitis?

Biceps tendinitis can result from:

• Repetitive overhead activity: Sports like baseball, tennis, swimming, or work-related activities that involve frequent overhead motion.

• Age-related wear: The tendon naturally weakens over time and can develop fraying or inflammation.

• Associated shoulder conditions: Biceps tendinitis often occurs alongside other shoulder issues, such as rotator cuff tears or impingement syndrome.

In some cases, the tendon may even partially tear or rupture if the degeneration is severe.

Symptoms of Biceps Tendinitis

Common symptoms include:

• Pain in the front of the shoulder, especially with overhead activity

• Tenderness over the bicipital groove (front of the upper arm near the shoulder)

• Aching pain at rest or at night

• Weakness or fatigue with lifting

• Occasional snapping or popping sensation in the shoulder

Diagnosis

Diagnosis is based on a careful physical examination and, when needed, imaging studies:

• Physical exam: Includes tests that place tension on the biceps tendon to reproduce symptoms.

• Ultrasound or MRI: Can show signs of inflammation, fraying, or associated conditions like rotator cuff tears.

Treatment Options

Most cases of biceps tendinitis improve with non-surgical treatments:

• Activity modification: Reducing overhead activities to allow the tendon to rest.

• Physical therapy: Focused on stretching, strengthening, and improving shoulder mechanics.

• Anti-inflammatory medications: Help reduce pain and swelling.

• Injections: Corticosteroid injections around the tendon can relieve inflammation if needed.

If symptoms persist or if the tendon is severely damaged, surgical treatment may be considered. Options include:

• Biceps tenodesis: Reattaching the tendon to the upper arm bone, relieving tension on the damaged portion.

• Biceps tenotomy: Releasing the tendon from its attachment at the labrum, usually reserved for lower-demand patients.

Surgical treatment is often performed alongside other procedures, such as rotator cuff repair, when multiple problems are present.

Recovery and Outlook

• Non-Surgical:
  Most patients improve with conservative care over several weeks to a few months.

• Surgical:
  If surgery is needed, recovery typically involves:

  • A period of rest and protection

  • Gradual return to motion and strengthening

  • Most patients return to normal activities within 3–4 months

Rehabilitation and proper shoulder mechanics are important to prevent recurrence.

Conclusion

Biceps tendinitis is a common cause of shoulder pain, especially in active individuals and those with overhead activity demands. Most cases respond well to non-surgical treatment, but persistent or severe cases may require surgical management.

If you’re experiencing front-of-shoulder pain or difficulty with overhead activities, contact our office for a full evaluation and personalized care plan.