Kellie K. Middleton, MD

What is Biceps Tendinitis, and How Is It Diagnosed?

Dec 14, 2021
What is Biceps Tendinitis, and How Is It Diagnosed?
The upper biceps, also known as the long head of the biceps tendon, is a cord-like structure that connects the biceps muscles to the bone in your shoulder socket...

Biceps Tendinitis is a condition where inflammation or irritation occurs at the upper biceps tendon leading to pain. The upper biceps, also known as the long head of the biceps tendon, is a cord-like structure that connects the biceps muscles to the bone in your shoulder socket. 

In the early stage, the tendon becomes swollen. As the tendonitis develops, the covering of the tendon called the tendon sheath starts to thicken. The tendon itself grows large and thickens. The tendon at a later stage turns dark red due to inflammation. If it’s not treated on time, the damage to the tendon can cause partial or complete tearing. 

Mostly, biceps tendinitis occurs along with other shoulder problems. In most cases, the rotator cuff tendons are also damaged. Some other problems that are associated with biceps tendinitis are –

  • Tears in the glenoid labrum
  • Arthritis of the shoulder joint
  • Dislocation of the shoulder
  • Shoulder impingement
  • Other diseases that may cause inflammation of the shoulder joint

Why is Biceps Tendinitis a Problem?

Biceps Tendinitis

An inflamed biceps tendon can rupture and tear, causing it to detach from one end of the bone to which it is attached. Tendon injuries do not repair themselves, while total ruptures will need surgery. 

If you are young and active, loss of strength is totally unacceptable, especially with the physical disfigurement of bulging biceps that have lost their tension. For a sportsperson, such injuries can end your career, unless it is fixed in a timely manner. 

One of the best ways to remain healthy, active and to avoid surgery is to prevent biceps tendinitis before they appear. You need to prevent tendon damage from getting serious. 

What is the Cause of Biceps Tendinitis?

People may develop biceps tendinitis as a form of repetitive strain injury. If you play a certain sport or have poor posture when working, they can tear the tendons in the biceps. 

Some other risk factors include –

  • Age – Older people are at a higher risk of biceps tendinitis due to wear and tear on their arm tendons. 
  • Repetitive Shoulder Action – Sports that need repetitive overhead actions of your arms can cause the tendon to wear more.
  • Activities Requiring Heavy Lifting – People who often lift heavy loads over their heads, in sport, work, or exercise. Such activities can lead to biceps tendinitis.
  • Smoking – According to a study by the American Academy of Orthopedic Surgeons, there is a link between smoking and poor tendon strength. 

Make sure to warm up well before any exercise and take breaks when performing repetitive movements. Make sure you perform all movements safely and do not take any unnecessary risks that can cause injury. If you are playing a new sport, take proper lessons to understand the techniques. 

What are the Symptoms of Biceps Tendinitis?

Biceps Tendinitis symptoms can be divided into two categories. The first is the common symptoms that most people suffering from biceps tendinitis experience, and the other is when the biceps tendon has ruptured. However, the symptoms may vary from person to person.

Common Symptoms

  • Shoulder Pain – The main symptom of biceps tendinitis is shoulder pain. The pain starts in the front part of the shoulder and then starts to move down the arm. The pain may start after a fall or an inciting event but can also start without any trigger. The pain may get worse when pulling, lifting, or carrying out repetitive action with your arm. 
  • Click Sound When Lifting Your Arm – You’ll find it painful to move your arm up and down, and you’ll feel your shoulder snapping as you move it. The pain often gets worse at night.  
  • Pain in the Upper Arm Near the Shoulder – When you push in front of the upper arm near the shoulder, you’ll experience pain. 

Symptoms of Biceps Tendon Rupturing

After a trauma or a fall, most people with biceps tendinitis may hear a pop sound. After that, they may experience swelling, pain, and bruising in the area. It happens when the bicep tendon has broken or ruptured. Some other symptoms that may be present include –

  • Pain resolves after rupture – Many people with existing biceps tendinitis may experience less or no pain at all once the bicep tendonitis has ruptured. 
  • Popeye arm – The middle of the arm may swell, which looks like the arm of the cartoon character ‘Popeye.’ It happens when the bicep muscles contract together into a very tight space. 
  • Weakness in the Elbow – In most cases, people find it difficult to flex their elbow once ruptured.

How Is Biceps Tendinitis Diagnosed?

Your surgeon will carry out an extensive medical and injury history. Later, they will perform a physical examination. The doctor will assess your shoulder for a range of strength, motion, and signs of shoulder instability during the examination.  In addition, your doctor will also order some tests to check the function of the biceps. 

The following tests will help your doctor confirm your diagnosis – 

  • X-Rays – Although X-rays show only your bones and not soft tissues like tendons, they can reveal other problems with your shoulder joint. It can help rule out any other symptoms that you may be experiencing. 
  • Magnetic Resonance Imaging (MRI) & Ultrasound – They can show tears of the tendon and allow the doctor to see the injury much clearly if they suspect a tear. 

What is the Treatment for Biceps Tendinitis?

Your orthopedic surgeon will identify any other problem with your biceps tendinitis and treat them along. They will develop a personalized treatment plan depending on the severity of the injury and the symptoms you are experiencing. 

Biceps tendinitis is typically treated with non-surgical treatments such as rest, ice, anti-inflammatory medicines, physical therapy, exercises, and corticosteroid injections. If the above treatment options are not working properly. Your doctor may recommend surgery if there is a tear that needs repairing. 

Biceps tendinitis usually heals in a few weeks to a few months and does not cause any long-term issues. It is important to rest and rehabilitate the shoulder and arm to allow it to heal completely. Slow return to sports or regular activities can help prevent biceps tendonitis from recurring.