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Bicep Tendonitis Overview

by Jaydee Vykoukal, PT, DPT May 28, 2020 0 Comments

Bicep tendonitis pain can range from mild to severe depending on the nature of the injury and can be accompanied by inflammation. As the injury progresses it can lead to poor quality of life and trouble completing normal daily activities. This can occur on either side of the bicep: in the forearm or, more commonly, in the shoulder. Keep reading to learn more about bicep tendonitis.

What is Bicep Tendonitis?

Bicep tendonitis develops when the tendons connecting to the bicep muscle become inflamed. The bicep is located on the front of the upper arm and is used to flex the elbow and provide shoulder stability. The muscle splits into two different sections at the top of the arm, known as the long head and short head. The long head bicep tendon attaches directly into the shoulder socket (near the top), while the short head tendon attaches to a bony process in the shoulder blade called the coracoid. The long head bicep tendon is the most common area to be affected by inflammation associated with bicep tendonitis. 

Causes of Bicep Tendonitis

Like most cases of tendonitis, the primary cause is typically related to overuse. However, there are other mechanisms of injury that may occur as well. These include:

  • Repetitive arm use that gradually strains the bicep
  • Continuous overhead motions, especially if it is weighted
  • Chronic shoulder instability that requires the muscles to work extra hard to protect the joints from injury
  • A direct blow to the shoulder
  • A fall that required you to catch yourself with your hand

Risk Factors

There are many different risk factors that can contribute to biceps tendonitis. These include:

  • Sports involving a lot of overhead or general upper arm movement and strength including swimming, tennis, volleyball, basketball, baseball, and skiing
  • Arthritic changes in the shoulder, typically from years of overuse
  • Previous shoulder injuries that put the shoulder at a biomechanical disadvantage, such as a dislocation or a rotator cuff or SLAP (bicep) tear 
  • Age-related changes to tissue health
  • Inflammatory diseases that increase the risk of injury and result in poor healing

Bicep Tendonitis Symptoms

Symptoms can vary based on which tendon is affected. Generally, symptoms include:

  • Pain in the front of the shoulder
  • Weakness of the bicep
  • Pain with overhead use of the arm
  • Tenderness directly at the anterior (front) humeral head
  • Redness and swelling in the anterior shoulder
  • A snapping sensation in the shoulder with specific aggravating moves (usually overhead reaching or a sudden move)


Traditionally, an in-depth exam can diagnose bicep tendonitis without the need for imaging. Assessment typically includes an in-depth history, strength, range of motion, special tests, and a full pain assessment.

If there is any concern about a potential tear or another injury at the shoulder, imaging may be used. An x-ray can rule out any potential bony injuries like fractures or arthritis. Alternatively, an MRI is a better option for assessing the overall tissue quality of the shoulder muscles and tendons.

Bicep Tendonitis Treatment & Recovery

Treatment for bicep tendonitis varies with severity. It is always best to start conservatively with options like rest, pain medication, an exercise program, massage, and modalities to promote healing. If you are comfortable, a lot of these can be initiated at home. Otherwise, professional guidance from your physician or physical therapist can help expedite the recovery process. Lastly, more invasive options like injections and even surgery can be utilized as needed.

Find a Selection of Exercises for Bicep Tendonitis Here.

Recovery time also depends on the severity of the injury and whether conservative or invasive treatment was needed. Tendonitis injuries typically take more time for recovery than a more acute injury because the symptoms come on slowly with years of overuse. For conservative treatment, you can expect to recover within 6-12 weeks. For surgical recovery, expect 12+ weeks to full recovery.

Managing Bicep Tendonitis

Now that you have a general understanding of bicep tendonitis, you should know what your next step is in managing your symptoms. With the right education, diagnosis, and recovery program in place, you can get back on track with normal life in less time.






Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

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