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Biceps Tendon Injuries: Causes, Symptoms & Treatments

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Bicep tendonitis develops when a tendon in the biceps muscle swells and becomes inflamed. It usually occurs with other problems with the shoulder, such as dislocation, impingement, or arthritis.

A tendon is a strong band of connective tissue that attaches muscle to bone. Tendonitis can cause a person to experience pain and stiffness. It can also limit mobility.

Biceps Tendon Injuries

In this article, we examine the causes and symptoms of tendonitis in the biceps muscle. We also look at the treatment options and recovery time for this type of inflammation.

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In the biceps, the tendon connects the biceps muscle to the shoulder and the elbow.

Two tendons connect the biceps muscle to the shoulder. One of them is the long head, which connects it to the top of the shoulder socket, or glenoid.

The other one is the short head, which connects it to the coracoid process, that is, the front of the shoulder blade.

The type of bicep tendonitis a person has depends on which tendon has become affected:

  • Distal bicep tendonitis: This is when inflammation occurs at the end of the tendon connecting the biceps muscle to the elbow.
  • Proximal bicep tendonitis: This is when there is inflammation at the end of the tendon connecting the biceps muscle to the shoulder.

Usually, a person will only have one type of tendonitis rather than experiencing it in both places at once.

Bicep tendonitis occurs when tendons in the biceps become inflamed. This can sometimes be due to microscopic tears.

Causes of bicep tendonitis can includeTrusted Source:

People may develop bicep tendonitis as a form of repetitive strain injury. If they have poor technique while playing a sport, or if they have poor posture while working, they may tear the tendons in their biceps.

Other risk factors include:

  • Age: Older adults have more wear and tear on their tendons, as they have more years of use.
  • Activities requiring overhead heavy lifting: Whether it is as part of work, sports, or exercise, people who lift heavy things over their heads, such as weightlifters or those with jobs requiring heavy labor, can cause extra wear and tear on their tendons.
  • Repetitive shoulder use: Sports that require repetitive overhead movements, such as swimming or tennis, can cause a tendon to wear more.
  • Smoking: According to the American Academy of Orthopaedic Surgeons (AAOS), there is a link between the use of nicotine and poor tendon quality and strength.

It is important to warm up well before any form of exercise and take regular breaks from any repetitive movements, especially overhead ones.

People should also make sure they are performing any movement safely and are not putting themselves at risk of injury. For example, if a person is playing a new sport, they might want to consider taking some lessons first to ensure they have proper technique.

Symptoms of bicep tendonitis may include:

  • pain that worsens with movement
  • difficulty moving the joint, which may lead to restricted mobility
  • muscle weakness
  • pain that worsens with overhead movement in particular
  • a clicking, grating, or snapping sensation with movement of the shoulder
  • swelling in the area, often co-occurring with heat or change in skin color
  • difficulty rotating the arm

A healthcare professional may useTrusted Source various tests to diagnose bicep tendonitis, including:

Physical examination

Taking a person’s medical history and discussing symptoms will enable a doctor to diagnose bicep tendonitis.

They may ask a person to demonstrate the limit of the mobility in the affected arm and compare it with that of the other arm.


Tests that can help diagnose bicep tendonitis include:

  • MRI scans: This scan type can show any tears of the tendon and enable doctors to clearly assess the injury.
  • X-rays: These cannot show soft tissues, such as tendons, but they can help rule out other causes of the symptoms a person is experiencing.

Depending on the severity of bicep tendonitis, different treatment strategies may be necessary.

Nonsurgical options

Mild bicep tendonitis may respond well to home remedies.

The AAOS recommends a person initially try:

  • Rest: Refrain from whatever activity initiated the pain and give the tendon time to heal.
  • Ice: Apply ice packs to the affected area for 20 minutes four to eight times per day.
  • Over-the-counter medication: Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, may help alleviate the pain and swelling from bicep tendonitis. This can be either in pill form or as a topical medication that a person applies directly to the skin in the form of creams, gels, or patches.
  • Physical therapy: Certain stretches and strengthening exercises may help a person regain their range of motion and strength in their arm and shoulder. It is important to only carry out stretches and exercises a healthcare professional has approved, to ensure the injury does not worsen.
  • Steroid injections: In some cases, a doctor may inject steroids directly into the tendon. While this can relieve pain and inflammation, on rare occasions, it can cause further weakness to the tendon, making the situation worse.

Unless a healthcare professional advises otherwise, it is important to gently use the arm as normally as possible when the symptoms ease, to ensure that the weakness does not continue.

Surgical options

Typically, tendonitis responds well to nonsurgical treatment.

However, if the condition is severe or worsens to an extent that the tendon tears completely or ruptures, surgical intervention may be necessary.

Sometimes, surgery involvesTrusted Source using an arthroscope, or small camera, that a surgeon inserts into the shoulder joint to assess the injury. They may also remove damaged tissue or repair the ruptured tendon.

The type of procedure required may depend on whether a person is experiencing distal or proximal bicep tendonitis.

People should discuss their options with a surgeon to ensure they receive the most appropriate care for their circumstances.

Mild tendonitis that a person can treat at home may resolve after 1–2 weeks. However, when a person requires surgery, the recovery time will be longer.

Individuals should speak with a healthcare professional about their specific case of tendonitis for more accurate information about the recovery time.

If people try to return to their normal levels of activity too soon, they may risk causing further injury to the bicep tendons, which may worsen the symptoms.

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