Tendons attach muscles to bones. The biceps tendon attaches the large muscle on the front side of your upper arm – the biceps - to the bones in the shoulder. There are 2 tendons called the long head and short head. The long head attaches the biceps muscle to the top of the shoulder socket, and the short head of the biceps tendon attaches to the coracoid [core-UH-coid} process, which is a bump on the shoulder blade. Biceps tendonitis [ten-duhn-EYE-tis] is when the long head of the biceps tendon becomes inflamed. When this happens, the tendon may swell and become red. As it gets worse, the outside of the tendon (the sheath) can thicken and darken in color. Sometimes tendonitis can cause the biceps or rotator cuff tendons to tear.
Biceps tendinitis often comes with other shoulder problems, such as:
- Rotator cuff injuries
- Shoulder arthritis
- Muscle tears
- Shoulder stiffness (impingement)
The most common symptoms of biceps tendinitis include:
- Pain in the front of the shoulder that is made worse when pulling, lifting, or doing repeated overhead activities.
- A dull ache that radiates from the upper arm to the elbow
- Popping or clicking near the shoulder that often gets worse at night
The symptoms of biceps tendinitis may be similar to other, more severe conditions. See a doctor if you have:
- Pain that doesn’t go away with rest or after using over the counter non-steroidal anti-inflammatory medicines (NSAIDs), such as aspirin, ibuprofen, or naproxen
- Pain that gets worse over time
- Loss of function or stability
- An odd shape or bulge in the muscle or shoulder
- A popping or tearing feeling in the shoulder or upper arm
To diagnose biceps tendinitis, your doctor will ask about your injury and medical history. The doctor will also look at your arm and shoulder and may press on the area to see if they can feel any hardness or swelling. You may be asked to move your arm to check for any problems with motion and strength
To confirm or rule out tendinitis, your doctor may order imaging tests, such as:
- Ultrasound to confirm the diagnosis of biceps tendon injury
- MRI (magnetic resonance imaging) to get more detailed images of the biceps tendon or other structures in the shoulder
- X-rays to rule out other problems with the bones or rotator cuff
Treatment will depend on the severity of the injury. If your tendinitis is mild, the doctor may recommend the following to relieve your symptoms:
- Rest. Take a break from your activities for 5 to 7 days.
- Ice. Place a cold pack on your shoulder and upper arm for 15 to 20 minutes at a time, 4 to 6 times a day to reduce inflammation.
- Medicine. NSAIDs (aspirin, ibuprofen, or naproxen)
- Exercise. Certain stretches or movements may help strengthen the surrounding muscles and relieve strain on the tendon.
If your case is more severe, your doctor may recommend steroid injections or additional physical therapy.
In the most severe cases, or if it does not get better with other treatments, your doctor may recommend surgery.
The best way to prevent biceps tendinitis is to:
- Warm up and stretch properly
- Use proper form and technique
- Take a break from your regular routine
- Use proper workplace supports, such as wrist guards for your mouse and keyboard, or ergonomic keyboards.