Biceps tendonitis happens when the tendon becomes irritated and inflamed, causing pain and limiting strength. Though any tendon can develop tendonitis, certain tendons are more vulnerable than others.

Tendonitis vs Tendinitis vs Tendinosis

First and foremost, it’s important to understand the difference between tendonitis, tendinitis and tendinosis.

Tendonitis and tendinitis are two different spellings of the same acute condition. Tendinosis, on the other hand, is a chronic condition caused by repetitive injury, trauma and/or untreated tendonitis.

What is biceps tendonitis?

The biceps muscle stretches from the radius bone at the elbow to the shoulder and connects to the shoulder joint via two tendons, called the long head and the short head. The long head of the biceps tendon (LHBT) runs up the length of the upper arm and attaches to the labrum and shoulder blade top of the shoulder joint. The short head of the biceps tendon attaches adjacent to the socket at the coracoid process (hook-like structure) on the front of the scapula.

Biceps tendonitis is most commonly inflammation of the biceps’ long head tendon at the shoulder joint. Approximately 5% of people with biceps tendonitis have what is called primary biceps tendonitis, which is inflammation of the LHBT where it lays within a deep groove in the humerus (upper arm bone). This is called proximal biceps tendonitis. The other 95% of people with this condition usually also have a rotator cuff tear or a SLAP (superior labrum anterior to posterior) lesion.  

This condition can also occur at the LHBT’s insertion at the elbow (called distal biceps tendonitis), though this is less common and it is rare to experience biceps tendonitis at both the shoulder and the elbow at the same time.

Common Symptoms

• Sharp pain in the front of the shoulder (especially when reaching overhead, across the body or behind the back)
• Pain that radiates down the front of the arm or from the shoulder to the neck
• Weakness around the shoulder joint
• A clicking, snapping or catching sound or feeling in the front of the shoulder with movement
• Achy, dull pain or tenderness at the front of the shoulder
• Pain when throwing a ball
• Pain that becomes worse at night

Causes

Unfortunately, biceps tendonitis can result from everyday activities, as wear and tear slowly irritate and weaken the tendon. Other common causes include:

• Repetitive overhead movement
• Weak upper back muscles
• Rotator cuff tears
• Shoulder joint hypermobility
• Shoulder joint and/or muscle tightness
• New and/or increased workout routine
• Weightlifting (particularly distal biceps tendonitis from biceps curls)

Treatment Options

In addition to RICE (rest, ice, compression, elevation) and NSAIDs (nonsteroidal anti-inflammatory drugs), your orthopedic specialist will most likely prescribe physical therapy to rehabilitate your biceps tendon(s). Physical therapy for biceps tendonitis usually includes range-of-motion exercises, manual therapy, functional training and pain management.

If these conservative approaches do not adequately rehabilitate the biceps tendon, steroid injections may be recommended. If you have additional shoulder injuries or issues, biceps tendon surgery may be a good option.

Biceps Tenodesis

In this arthroscopic surgical procedure, the damaged section of the biceps tendon is removed and the remaining tendon is reattached to the humerus to relieve symptoms and restore function.

Tenotomy

If the long head of the biceps tendon is too damaged to repair via biceps tenodesis, your orthopedic surgeon may choose to release the damaged biceps tendon from the scapula. This option, while the least invasive and very effective for reestablishing strength, may result in a “Popeye bulge” in the arm.

How long does biceps tendonitis take to heal?

Biceps tendonitis can take anywhere between six weeks and six months to heal properly, with or without surgery. The exact biceps tendonitis recovery time varies from person to person, injury to injury.

If you’re experiencing pain in your biceps, shoulders or elbows and would like to talk to one of our orthopedic specialists, please contact us today or comment below.