Biceps Tendonitis

Written by Dr. Jason Ngan, DC

What is Biceps Tendonitis?

Biceps tendonitis is an inflammation of the biceps brachii tendon. The biceps brachii is a thick muscle located at the front of the upper arm. The biceps muscle split into two tendons at the shoulder, named short and long head of the biceps. Biceps tendonitis usually occurs to the top tendon (long head).

What Causes Biceps Tendonitis?

Biceps tendonitis is caused by micro tearing in the tendon from overuse or exerting too much strength. The long head of the biceps tendon travels in an indentation called the bicipital groove at the upper arm bone (humerus). Excessive motion and force in this small space damages and inflames the tendon causing biceps tendonitis.

  • Repetitive motions of the arm (throwing, serving, swinging golf club)

  • Excessive force of the arm (weightlifting)

What are the Signs and Symptoms?

  • Pain and tenderness at the anterior part of the shoulder

  • Pain upon movement of the arm such as raising or turning

  • Shoulder stiffness

  • Weakness at the shoulder especially lifting objects overhead

How is Biceps Tendonitis Diagnosed?

Biceps tendonitis is diagnosed with a thorough medical history, physical examination, orthopedic testing, and diagnostic ultrasound.

  • Muscle weakness.

  • Abnormal sensation (pain, burning, numbness).

  • Orthopedic tests narrows down which muscle is affected.

  • Diagnostic ultrasound can visualize which structure is affected.

What are the Treatment Options?

Biceps tendonitis can be treated with rest. There are some therapies that can speed up the recovery process. Some options we provide are:

  • Chiropractic manipulation and mobilization

  • Soft tissue therapies

  • Gua-sha

  • Cupping

  • E-stim

  • Ultrasound

  • Ergonomic counseling

  • Rehabilitative exercises & stretches

Other treatments that patients may seek (not provided at Ngan Chiropractic) include acupuncture, non-inflammatory medications, steroid injection, and surgery if severe.

References

  1. Lewis RB, Reyes BA, Khazzam MS. A Review of Recent Advances in the Diagnosis and Treatment Modalities for Long Head of Bicep Tendinopathy. Clinical Medicine Insights: Trauma and Intensive Medicine. 2016;7. doi:10.4137/CMTIM.S39404

  2. Pfefer MT, Cooper SR, Uhl NL. Chiropractic management of tendinopathy: a literature synthesis. J Manipulative Physiol Ther. 2009 Jan;32(1):41-52. doi: 10.1016/j.jmpt.2008.09.014. PMID: 19121463.

  3. Raney EB, Thankam FG, Dilisio MF, Agrawal DK. Pain and the pathogenesis of biceps tendinopathy. Am J Transl Res. 2017 Jun 15;9(6):2668-2683. PMID: 28670360; PMCID: PMC5489872.

  4. Varacallo M, Mair SD. Proximal Biceps Tendinitis and Tendinopathy. [Updated 2022 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK533002/