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Biceps Tendinopathy
The biceps has tendons at both ends, and either can become painful. At the shoulder, the long head runs through a groove at the front and is a common source of front-of-shoulder pain; at the elbow, the tendon can be irritated by repeated heavy lifting. Both respond to graded loading, and both are frequently found alongside a rotator cuff problem.
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Does this sound like you?
Most people have several of these, not all of them.
- Pain at the front of the shoulder, sometimes running down the upper arm
- Discomfort lifting with the palm facing up
- An ache that is worse after activity than during it
- Tenderness to press in the groove at the front of the shoulder
- Occasional clicking as the tendon moves in its groove
Why it happens
- Repeated overhead reaching or lifting
- A sudden heavy lift, particularly with the palm up
- An underlying rotator cuff problem changing how the shoulder moves
- Age-related tendon change
- Heavy resistance training with rapid progression
What we would do about it
Roughly in this order — each step waits for the one before it.
- Progressive loading of the tendon in the range that provokes it
- Rotator cuff and shoulder blade strengthening, since the cuff is usually involved
- Manual therapy and soft tissue work for symptom relief
- Modifying rather than stopping the aggravating activity
- Technique review for lifting and training
- Referral for imaging where a rupture is suspected
See a doctor first if
- Your pain followed a significant injury
- It is getting worse rather than settling
- It comes with numbness, weakness or unexplained weight loss
This page is general information, not a diagnosis. Symptoms overlap between conditions, so the right treatment depends on an assessment.
Front-of-shoulder pain is rarely just the biceps
The biceps tendon is usually irritated because something else in the shoulder has changed. Finding that is what stops it recurring. Ask a question first, or call us on 0403 907 587.
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Other arm conditions we treat
Related reading: the cuff problem that usually accompanies it, front-of-shoulder pinching and elbow tendon pain.
General information only, not advice about your own problem — nothing here replaces an assessment. Source: Biceps Tendinopathy on Physiopedia.
