Biceps Tendonitis
What Is Biceps Tendonitis?
The biceps muscle has a long tendon that travels from the muscle, through the front of the shoulder, and attaches inside the joint near the labrum. This long stretch of tendon runs through a narrow groove at the front of the shoulder, making it prone to irritation and inflammation — a condition known as biceps tendonitis. It frequently occurs alongside other shoulder problems, particularly rotator cuff irritation, since the two structures sit close together.
What Causes Biceps Tendonitis?
- Repetitive overhead activity, such as throwing, swimming, or overhead lifting
- Age-related wear of the tendon over time
- Impingement, where the tendon gets pinched between the surrounding bone and soft tissue during overhead motion
- Direct irritation from other shoulder problems, including rotator cuff tears or shoulder instability, which can place added stress on the biceps tendon
What Are the Symptoms of Biceps Tendonitis?
- Pain at the front of the shoulder, often radiating down toward the front of the arm along the path of the tendon
- Pain that worsens with overhead activity or reaching
- A deep ache that may worsen at night, particularly when lying on the affected shoulder
- Occasional clicking or catching sensations with shoulder movement
- Tenderness when pressing directly over the front of the shoulder along the tendon’s path
Is Biceps Tendonitis the Same as a Biceps Tear?
No, though the two are related and exist on a spectrum. Tendonitis refers to irritation and inflammation of the tendon that is still fully intact, while a tear involves an actual disruption of the tendon fibers, ranging from a partial fraying to a complete rupture. Chronic, untreated biceps tendonitis can weaken the tendon over time, which is one reason why longstanding biceps pain is sometimes associated with an eventual tear — but tendonitis alone does not mean the tendon has torn.
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Treatment Options for Biceps Tendonitis
The great majority of biceps tendonitis cases improve with nonsurgical treatment:
- Rest and activity modification, temporarily avoiding aggravating overhead motions
- Physical therapy focused on shoulder mechanics and flexibility
- Anti-inflammatory medication
- Corticosteroid injections for more persistent cases
- Addressing any underlying rotator cuff or shoulder instability issues contributing to the irritation
Surgery is rarely needed for isolated biceps tendonitis and is generally reserved for cases that don’t improve after a thorough course of nonsurgical treatment, or for tendonitis that progresses to a significant tear.
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Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.