Bicep Tendonitis: Causes, Symptoms, And The Best Treatment For It!!

Bicep Tendonitis

Bicep tendonitis is one of the most common gym injuries that can prevent you from functioning. However, the ironic part about this injury is that the problem is probably not caused by your biceps workouts and exercises in the first place.

It is the upper biceps tendon’s inflammation or irritation. Recurrent tendon microtrauma, overused and repetitive overhead activity, leads to tendonitis of biceps.

Sports such as baseball, tennis, swimming or lifting weights are included in these activities. Usually occurs in conjunction with other shoulder issues such as shoulder impingement, glenoid labrum tears, shoulder instability, shoulder joint arthritis, and tears of the rotator cuff. Impingement of the shoulder is a major cause of tendonitis of biceps.

In this article, I’ll show you the real cause of bicep tendonitis, symptoms, tests to determine and the best treatments you can go for to be able to continue your biceps workouts despite dealing with this issue.

Where is Bicep Tendonitis Located?

The muscle of biceps is in your upper arm’s front. It has two tendons attaching it to the shoulder’s bones. The long head is attached to the socket (glenoid) of the shoulder.
The long head of the biceps passes over the head of the humerus and attaches to the top of the socket of the shoulder. Biceps long head acts as a shoulder joint stabilizer through humeral head depression. On the front of the shoulder ball, the biceps tendon travels through the bicipital groove, where most inflammation (usually related to friction) occurs.


Biceps anatomy is an important starting point when discussing the issue of tendonitis of biceps. The muscle of biceps goes from the shoulder to the elbow on the upper arm’s front. The upper part of the biceps muscle is connected to the shoulder by two separate tendons (tendons attach muscles to bones). The upper two biceps tendons are called the biceps tendons because they are closer to the top of the arm.

The biceps ‘ long head is the main proximal tendon. It connects the muscle of biceps to the top of the socket of the shoulder, the glenoid. It also blends around the glenoid, which is called the labrum, with the cartilage rim. The labrum is a soft tissue rim which transforms the glenoid’s flat surface into a deeper socket. This arrangement enhances the fit of the humerus ball (humeral head) into the socket.

The tendon of the long head of the biceps runs in front of the humeral head starting at the top of the glenoid. The tendon passes through the humerus ‘ bicipital groove and the transverse humeral ligament holds it in place.

This anatomy design keeps the humeral head within the glenoid from sliding too far up or forward. Biceps ‘ short head connects to the scapula’s coracoid process (shoulder blade). The coracoid process is just in from the front of the shoulder a small bony knob. The lower tendon of biceps is called the tendon of distal biceps.

The word distal means that the tendon is down the arm further. This tendon connects the lower part of the biceps muscle to the forearm. The muscles that form the short and long biceps heads remain separate up to just above the elbow, where they unite and connect to the distal tendon of the biceps.

Biceps muscle contracting can bend the elbow upward. The biceps can also help move the shoulder by lifting the arm in front of the body, a movement called flexion of the shoulder. The muscle of biceps can also rotate, or twist, the forearm in a way that points up the hand’s palm. This movement is called supination, which positions the hand as if you were holding a tray.

What Causes Bicep Tendonitis?

If the rotator cuff muscles do not have adequate strength, the humerus head migrates upward in the socket whenever you do any overhead lifting exercise.

As in the bottom of a pull-up, it is possible to descend through a rep and have your upper arm travel over your head. The important idea is that if you have an unbalanced rotator cuff, you may have a problem once the arm travels past shoulder height.

When this happens without sufficient strength, your humeral head will migrate too far upwards. This can cause the structures that sit just above the humeral head and just below the shoulder joint’s acromion or roof to pinch and impinge.

The tendon of the biceps ‘ long head is jammed against the joint’s roof and is pinched. Repeating this process over and over (as with any series of sets and repetitions in exercises that place the arms overhead) will result in a possible breakdown and tendon fraying.

Usually, the first stage of this is seen in an inflamed tendon of biceps that results in bicep tendonitis. The irony again is that the condition is probably not aggravated by traditional biceps curls.

Indeed, by stimulating blood flow to the muscle, you can actually help the situation speed up healing by including curls instead of avoiding them when it hits. However, the amount of overhead pressing, bench pressing or even the position of your arms during squatting is what you would like to change.

All of these exercises are much more likely to bother a bad shoulder once it is already inflamed or they are causing the pain in the first place. Make adaptations to your training to continue to workout without having to skip arm day all together.

How Does it Feel?

Resting the shoulder will usually alleviate the pain. By attempting to bend the elbow or by twisting the forearm into supination (palm up), the arm may feel weak. Felt near the top of the biceps muscle, a catching or slipping sensation may suggest a tear of the transverse humeral ligament.

Patients suffering from bicep tendonitis and tendinopathy will commonly report: pain in the anterior shoulder region above the bicipital groove, sometimes radiating down to the elbow.

Some patients describe muscle weakness and with shoulder movements clicking or snapping. Rest and ice alleviate the symptoms.

Some of the main culprits are racket and ball throwing sports, but any repetitive movement of the shoulder can cause an overuse injury. Typically, bursitis, tendinopathy or rotator cuff injury can cause shoulder pain that gets worse at night. … In these tendons, rotator cuff injuries typically involve a tear.


Some people with biceps tendonitis may hear a sudden “pop” sound, followed after a powerful event by pain, swelling, and bruising in the shoulder. This can happen if the tendon of the biceps breaks or breaks. There may also be the following details:

  • After the rupture, pain may resolve: Sometimes if pre-existing biceps tendonitis has occurred, the pain may actually feel better right after the tendon rupture.
  • “Popeye “arm: you may notice a bulging muscle in the middle of the upper arm that looks similar to the” Popeye “cartoon character arm. This is because of the muscle of biceps contracts into a tight space together.
  • Elbow weakness: In some cases, after this happens, you may experience weakness in bending the elbow.

Types of Examination To Figure It Out

Speed test

The arm is supposed to to be supinated and the elbow extended. The patient is asked to actively flex the shoulder while the examiner applies movement resistance. Tenderness over the bicipital groove indicates long biceps head tendonitis.

Hook test

Diagnosis of distal biceps tendon rupture or tear. To hook the biceps tendon from the lateral side of the elbow, the examiner will use the index finger.

How do you do the hook test?

-The patient bends the elbow to 90 degrees and supinates the forearm completely. Using the index finger to hook the biceps tendon’s lateral edge.

– If the tendon is intact or partially torn, the finger under the tendon will be inserted and hooked.

-If the tendon cannot be hooked, this means that the distal biceps tendon has a complete tear.

-The hook test may involve false positives, such as partial distal biceps tears, intact lacertus fibrosis, or mistakenly hooking the tendon of the brachialis.

Squeeze test

Another test that can be used to diagnose distal rupture of the tendon biceps is the squeeze test.

Thompson’s test

The squeeze test is similar to the test used by Thompson to diagnose Achilles tendon rupture.

Flex the elbow to 80 degrees and in some pronation keep the forearm. Then with one hand or two hands squeeze the biceps. The forearm’s supination will occur if the biceps are intact.

There will be no forearm supination if the biceps are torn. Differentiating between partial and complete tears is the problem with diagnosing distal biceps tendon tears because both have the same clinical pictures.

With a complete distal biceps tear, you could see a palpable defect that could help the diagnosis. Partial tendon tears of biceps are rare and often misdiagnosed. The patient will have elbow pain and a normal hook test will also be performed by the patient.


Treatment will depend on the severity of the injury.

For Mild Bicep Tendonitis:

  • Rest- Take a break from your activities for 5 to 7 days.
  • Ice- Place a cold pack for 15 to 20 minutes at a time on your shoulder and upper arm, 4 to 6 times a day to reduce inflammation.
  • Medicine- NSAID (aspirin, ibuprofen, or naproxen).
  • Exercise- Some stretches or movements may help strengthen the muscles around and relieve tendon strain.

For More Severe Case:

Physical Therapy

If your symptoms persist (it’s been going on for over 2 weeks), then you’ve got to the point where you need to see a physical therapist. Try your best to explain where your pain is and what movements make it worse during your appointment. Your posture and your entire upper extremity, including your neck and shoulder girdle, should be included in an extensive physical examination.

Your doctor will evaluate your shoulder for range of motion, strength, and shoulder instability signs during the examination. He or she will also perform specific physical tests to check your biceps ‘ function. The doctor will then recommend certain stretching and reinforcing exercises for biceps after the test.

These stretching and reinforcing exercises can help restore your motion range and reinforce your shoulder.

For Most Severe Case:


If conservative treatment does not improve the condition. Tenotomy of biceps: Damaged tendon of biceps is released from the attachment. Cut the tendon of the biceps and let it fly. Done in patients with elderly and low demand.

Patients may experience subjective cramping. May result in a bulge of Popeye. The biceps ‘ damaged section is removed. The upper bone (humerus) is attached to the remaining tendon. Usually done for patients with high demand.

Biceps tendon rupture

The tendon of biceps may break at the top of the bicipital groove or may break at the elbow’s radial tuberosity.


In the groove of the bicipital. Muscle is moving to the elbow (Popeye). With a long head rupture, there is minimal loss of function as the short biceps head remains attached to the coracoid process.


The elbow’s radial tuberosity. When the tendon breaks, “pop” felt at the elbow. Rupture must be repaired otherwise a loss of bending and supination will occur.


It is possible to treat proximal ruptures either conservatively or surgically. After 4 – 6 weeks, it will become asymptomatic non-operatively for the elderly and most patients. Includes physical therapy, ice and rest.

The torn section of the tendon is attached to the bone (tenodesis) by surgical treatments. Usually, it is done in conjunction with other reconstructive surgery. The torn section of the tendon is rarely attached to the bone by surgical treatments (tenodesis).

Usually, it is done in conjunction with other reconstructive surgery. Rarely done in Cosmetics. Tenodesis is used to treat distal biceps tendon avulsion using sutures to anchor the tendon in the radius.

Biceps tendon subluxation or dislocation:

It is possible to injure the transverse humeral ligament and pulley system that holds the biceps tendon within the groove of the bicipital.

How Long Does It Take To Recover?

If you have tendonitis of biceps, moving your arm can hurt. The good news is that most cases are healing along with rest and medication.

Your biceps muscle needs about 3 to 4 months to heal. At first, the exercises will help you, and then your doctor or physiotherapist will give you the exercises you need to do on your own. In 2 to 3 weeks, you may be able to do easier daily activities as long as you don’t use your injured arm.

When To Go For A Professional

You should go to Professional Help immediately if you have any of these:

  • Fever of 100.4 ° F (38 ° C) or higher, or as directed
  • Symptoms that don’t get better with treatment, or worse
  • Weakness or instability in the arm or shoulder
  • Sudden sharp pain, bruising, swelling, snapping, or upper arm or shoulder bulging.
  • New symptoms

Preventive Measures

There are many steps you can take to prevent bicep tendonitis, such as:

  • Regularly perform shoulder and rotator cuff reinforcement exercises.
  • Set aside time to rest your shoulder and other joints, including at least two days off from sport per week and two months off per year.
  • Ask your physical or occupational therapist about the risks in your work environment and daily movements. Also, use a proper posture in your everyday activities.
  • Avoid lifting or carrying heavier objects away from your body when lifting or carrying them. Keep them close to your core and carry hands as well as arms.

So, this was a complete article on Bicep Tendonitis, I hope you find it helpful. Feel free to share your opinions in the comments below, share it with your friends and family to let them, groom. And do join softiview to get updated to more awesome posts like this!

Thanks for reading…

" Rohit Sahu : @   Rohit Sahu is a Professional Health & Fitness blogger & CEO of Softiview. Rohit likes to make valuable health-related posts that are definitely worth reading and will change your life completely…."

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