Biceps Tendonitis

Comprehensive guide to understanding, treating, and recovering from biceps tendonitis with evidence-based rehabilitation protocols and prevention strategies.

30-50

Peak age range

6-12

Weeks recovery

90%

Success with conservative care

15%

Athletes affected

Understanding Biceps Tendonitis

What is Biceps Tendonitis?

Biceps tendonitis is inflammation of the long head of the biceps tendon as it passes through the bicipital groove of the humerus, often causing anterior shoulder pain.

Common Risk Factors:

Repetitive overhead activities
Poor shoulder mechanics
Age-related degeneration
Shoulder impingement syndrome

Common Symptoms

Anterior shoulder pain
Pain with overhead reaching
Tenderness in bicipital groove
Pain with lifting or carrying
Weakness with elbow flexion
Night pain disturbing sleep

Types of Biceps Tendonitis

Primary Biceps Tendonitis

Inflammation of the long head of biceps tendon in the bicipital groove

Common Causes:

Repetitive overhead activities
Poor shoulder mechanics
Muscle imbalances
Age-related degeneration

Symptoms:

Anterior shoulder pain
Pain with overhead reaching
Tenderness in bicipital groove
Pain with resisted biceps contraction

Treatment Approach:

Conservative management with activity modification and strengthening

Secondary Biceps Tendonitis

Biceps inflammation secondary to other shoulder pathology

Common Causes:

Rotator cuff impingement
Shoulder instability
Labral tears
AC joint arthritis

Symptoms:

Combined shoulder symptoms
Multiple pain locations
Functional limitations
Night pain

Treatment Approach:

Address underlying pathology along with biceps-specific treatment

Biceps Tendon Rupture

Complete or partial tear of the biceps tendon

Common Causes:

Sudden forceful contraction
Chronic tendon degeneration
Heavy lifting with poor form
Age-related weakening

Symptoms:

Sudden "pop" sensation
Visible muscle bulge ("Popeye" sign)
Immediate pain and weakness
Bruising in upper arm

Treatment Approach:

May require surgical repair in younger, active individuals

Treatment Phases

Phase 1: Acute Management (0-2 weeks)

Initial inflammation control and pain reduction

Goals:

Reduce pain and inflammationProtect healing tissueMaintain pain-free motion

Key Interventions:

Activity modification and rest

Ice therapy 15-20 minutes, 3-4 times daily

Anti-inflammatory medications as prescribed

Gentle range of motion exercises

Avoid overhead activities

Ergonomic modifications

Phase 2: Early Mobilization (2-6 weeks)

Gradual restoration of function and mobility

Goals:

Restore full range of motionBegin gentle strengtheningImprove daily function

Key Interventions:

Progressive stretching exercises

Postural correction training

Scapular stabilization exercises

Isometric strengthening

Manual therapy techniques

Activity progression guidelines

Phase 3: Strengthening (6-12 weeks)

Progressive strengthening and return to activity

Goals:

Build biceps and rotator cuff strengthRestore functional movementPrevent recurrence

Key Interventions:

Progressive resistance exercises

Eccentric strengthening program

Functional movement training

Sport-specific exercises (if applicable)

Biomechanical assessment

Return to activity planning

Rehabilitation Exercise Program

Early Phase Exercises (0-6 weeks)

Pendulum Swings

Gentle passive movement to maintain mobility

Sets: 2-3 sets

Reps: 10-15 each direction

Frequency: 3-4 times daily

Passive Flexion Stretch

Use opposite arm to gently lift affected arm overhead

Sets: 3 sets

Reps: 30-second holds

Frequency: Daily

Cross-body Stretch

Gentle stretch across body to improve flexibility

Sets: 3 sets

Reps: 30-second holds

Frequency: 2-3 times daily

Strengthening Phase (6-12 weeks)

Biceps Curls (Light Weight)

Controlled biceps strengthening with light resistance

Sets: 2-3 sets

Reps: 12-15 repetitions

Frequency: Daily

External Rotation

Rotator cuff strengthening with resistance band

Sets: 2-3 sets

Reps: 12-15 repetitions

Frequency: Daily

Scapular Retraction

Strengthen muscles between shoulder blades

Sets: 2-3 sets

Reps: 15-20 repetitions

Frequency: Daily

Advanced Phase (12+ weeks)

Eccentric Biceps Curls

Slow, controlled lowering phase emphasis

Sets: 3 sets

Reps: 8-12 repetitions

Frequency: 3-4 times per week

Functional Reaching

Sport or work-specific movement patterns

Sets: 2-3 sets

Reps: 10-15 repetitions

Frequency: Daily

Plyometric Exercises

Advanced power and coordination training

Sets: 2-3 sets

Reps: 8-10 repetitions

Frequency: 2-3 times per week

Prevention Strategies

Proper warm-up before activities

Gradual progression in training intensity

Maintain good shoulder and elbow flexibility

Strengthen rotator cuff and scapular muscles

Use proper lifting techniques

Avoid repetitive overhead activities when fatigued

Address shoulder impingement early

Maintain good posture during daily activities

When to Seek Medical Attention

Sudden severe pain or "pop" in shoulder

Visible muscle bulge in upper arm ("Popeye" sign)

Complete inability to flex elbow against resistance

Numbness or tingling in arm or hand

Signs of infection (fever, increased warmth)

Progressive weakness despite treatment

Severe night pain disrupting sleep

No improvement after 6-8 weeks of conservative treatment

Shoulder Support

Supportive braces for activity modification

Resistance Bands

Essential for progressive strengthening

Ice Therapy

Cold therapy for inflammation control

Labral Tears Back to Shoulder Conditions Shoulder Arthritis

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