Biceps tendonitis is inflammation or irritation of the upper biceps tendon, called the long head, which connects your biceps muscle to the bones in your shoulder joint. Biceps tendonitis is typically caused by repetitive motion in sports or work activities, so it can develop at the same time as rotator cuff tendonitis because it is part of the rotator cuff structure.
Biceps tendonitis: causes, risk factors and common signs and symptoms
Biceps tendon injuries are most often caused by physical activities over time, because as we age, our tendons weaken with everyday wear and tear. This degeneration is worsened by repeating the same arm and shoulder motions, especially with repetitive overhead motion. Sports activities such as swimming, tennis, and baseball are risk factors for biceps tendinitis. A sudden and serious load to the biceps tendon can also cause tendonitis, which can happen at work or play.
According the American Academy of Orthopaedic Surgeons, the common symptoms of biceps tendonitis include:
- Pain or tenderness in the front of the shoulder, which worsens with overhead lifting or activity
- Pain or achiness that moves down the upper arm bone
- An occasional snapping sound or sensation in the shoulder
Biceps tendinitis often occurs along with damage to the rotator cuff tendon and shoulder problems, such as:
Diagnosis and treatment of biceps tendonitis
Your UCHealth specialist will take your complete medical history and injury history, and will perform a physical examination. The specialist will perform tests on your injured biceps to check function, and will also examine your shoulder for range of motion, strength and signs of instability. He/she may also order diagnostic imaging tests such as:
- X-rays. Although an X-ray only visualizes bones, it may show other problems in your shoulder joint.
- Magnetic resonance imaging (MRI) and ultrasound. Can show soft tissues like the biceps tendon in greater detail.
Your orthopedic and sports medicine specialist will develop a personalized treatment plan based on the severity of your tendonitis, symptoms you’re experiencing, and your desired activity level. We typically treat biceps tendonitis with nonsurgical treatments, such as:
- Ice. Use cold packs for 20 minutes at a time, several times a day, to keep swelling down.
- Nonsteroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling.
- Rest. Avoid activities that cause pain.
- Corticosteroid injections. Can be very effective at relieving pain and reducing inflammation medicines. Your provider injects this steroid directly into your tendon.
- Physical therapy. A physical therapist will teach you stretching and strengthening exercises to help restore range of motion and strengthen your biceps and shoulder structure.
- Prevention. Because most cases of tendonitis are caused by overuse, you will need to avoid or alter the activities that caused your injury.
If these treatment options aren’t working well enough, your provider may recommend surgery. Surgery may be the best option if you also have a related shoulder condition that requires repair. Our orthopedic surgeons are skilled at any of the latest orthopedic procedures, including:
- Biceps tenodesis. Your surgeon removes the damaged section of the biceps, and the remaining tendon is reattached to the upper arm bone (humerus).
- Tenotomy. In severe cases, your surgeon releases the damaged biceps tendon from its attachment.
Our patients typically regain full range of motion and are able to move their arms without pain. If you’ve had surgery and you play overhead sports like tennis, though, you might need to limit how often you play.
Whatever your job or favorite sports might be, we’ll work with you on the ideal treatment plan to help you return to those activities free of biceps tendonitis.
Orthoinfo. Biceps Tendinitis (https://orthoinfo.aaos.org/en/diseases–conditions/biceps-tendinitis/)
American Family Physician. Diagnosis and Treatment of Biceps Tendinitis and Tendinosis (https://www.aafp.org/pubs/afp/issues/2009/0901/p470.html)
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Sports Injuries: Diagnosis, Treatment, and Steps to Take (https://www.niams.nih.gov/health-topics/sports-injuries/diagnosis-treatment-and-steps-to-take)