If you happen to have pain in your upper arm or shoulder, you may have irritated your biceps tendon, a condition better known as biceps tendonitis. The pain may limit your shoulder motion and make performing daily work and recreational tasks hard or nearly impossible. 

Physical therapy for biceps tendonitis can be aid in lowering pain, improve shoulder strength and range of motion (ROM), and improve functional mobility and use of your arm.

Anatomy of the Biceps

Your biceps muscles are located in the front of your upper arms. They course from two heads (hence the name “biceps”) near your shoulder joint. The short head of the biceps comes up from the coracoid process of your shoulder blade.

The long head of the biceps originates from the supraglenoid tubercle of your shoulder joint and is encased in a synovial sheath. This sheath provides lubrication to the tendon and gives it an opportunity to glide and slide casually in the front of your upper arm. The biceps muscle travels down your upper arm and inserts on the radial tuberosity of your forearm.

While the function of your biceps is to turn your forearm into a palm up position, in addition, it works to help move your shoulder joint and assists the rotator cuff muscle group in stabilizing the front of your shoulder. Overloading of the biceps tendon at your shoulder or elbow may result in biceps tendonitis.

Injury to the Biceps Tendon

Biceps tendonitis is usually caused by overloading and overusing the biceps tendon. This often happens in repetitive overhead activity, such as racquet sports or when throwing a baseball.

The biceps muscle helps to slow down your elbow as it is extending, and over excessively using it in repetition may place a good amount of stress on the tendon, resulting in inflammation.

There is a ligament that courses over the long head of the biceps tendon, and this may thicken as you age because of the repeated micro-trauma to the area. This thickening of the ligament may cause abnormal rubbing on the tendon, leading to inflammation and irritation.

Since the biceps tendon works to stabilize the front of your shoulder, it may become overworked if you have shoulder instability or rotator cuff tear. When a rotator cuff muscle is torn, your biceps tendon may overwork to help stabilize the area, leading to biceps tendonitis.

It should be addressed that the initial injury and inflammation of the biceps tendon is called tendonitis. Long-term biceps tendon problems are most of the time referred to as biceps tendonopathy.

Known Symptoms of Biceps Tendonitis

There are a handful of symptoms of possible biceps tendonitis. Some of these may include:

  • Pain in your upper arm and shoulder
  • Difficulty lifting your arm up
  • Feelings of weakness in your arm
  • Tenderness to touching in the front of your upper arm and shoulder

If you think you have biceps tendonitis, you should visit your physician right away to get a diagnosis. That way, you can be certain to begin on the right treatment for your condition.

Diagnosis of biceps tendonitis involves performing a clinical examination of your shoulder, elbow, and upper arm. Your physician may order diagnostic tests such as magnetic resonance imaging (MRI) to view the soft tissue structures around your shoulder. This can confirm (or rule out) biceps tendonitis.

Biceps tendonitis may be hard to diagnose, as other conditions may present as anterior shoulder pain. These may include:

  • Rotator cuff tear
  • AC joint arthritis
  • Shoulder labrum injury
  • Or cervical (neck) radiculopathy.