Massage therapy · Kitchener–WaterlooBiceps Brachii Tendinopathy

Biceps brachii tendinopathy is irritation and damage of the tendon that connects the biceps muscle, at the front of the upper arm, to the shoulder (the long head of the biceps tendon) (AAOS, n.d.). It used to be thought of mainly as inflammation, but it often involves wear and tear (degeneration) of the tendon from overuse and ageing (Churgay, 2009). The main function of the biceps is to bend your elbow and to rotate your forearm. The tendon of the biceps runs through a narrow groove in the upper arm bone (humerus), where it can become irritated (Churgay, 2009).

Biceps Brachii Tendinopathy Anatomy

Biceps tendinopathy causes pain and tenderness at the front of the shoulder, which often gets worse with overhead lifting or activity and may spread down the upper arm (AAOS, n.d.). The tendon is prone to overuse injuries, especially in people who repeat the same shoulder movements again and again, for example in their job or in overhead sports such as swimming, tennis and volleyball (AAOS, n.d.). The condition is often confused with tendinopathy of the rotator cuff (Churgay, 2009). About 95 percent of cases happen alongside other shoulder problems, such as rotator cuff tears or impingement, rather than on their own (Churgay, 2009). It can also occur with tears of the rim of cartilage around the shoulder socket (the labrum) and shoulder instability (AAOS, n.d.).

How to Treat Biceps Brachii Tendinopathy

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Before returning to activity, make sure you have full range of movement and full strength in the shoulder. Going back too soon can cause more problems than it is worth in the end.
• Avoid activities that cause pain. Also be cautious with weight training and heavy lifting while the tendon settles.
• Avoid overhead activities that bring on your pain. As well as tenderness, you may notice an occasional snapping sound or feeling in the shoulder (AAOS, n.d.).
• Follow the exercises I give you.
• Change your position regularly when working, to minimise pain and potential overuse.

Biceps tendon pain at the front of the shoulder usually comes from asking the tendon to handle more than it's ready for, and it often goes along with other shoulder problems. My aim is to calm it down, take strain off the tendon, then build its strength back up gradually so your shoulder copes with lifting, reaching and sport again.

I start by assessing how your shoulder, shoulder blade and neck move, testing the strength of your shoulder and arm, and asking about your work, training and what brings the pain on. Because this tendon is rarely the only problem, I check the rotator cuff and the rest of the shoulder too, so we treat the whole picture.

When It's Sore

• Cutting back the lifting and overhead movements that flare it, rather than stopping everything
• Gentle, pain-free movement so the shoulder doesn't stiffen
• Hands-on work for the biceps, shoulder and upper back muscles, leaving the sore tendon mostly alone
• Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
• Taping to take some strain off in the short term

As It Settles

1. American Academy of Orthopaedic Surgeons (AAOS) (n.d.) Biceps tendinitis. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/biceps-tendinitis/ (Accessed: 7 October 2026).
2. Churgay, C.A. (2009) 'Diagnosis and treatment of biceps tendinitis and tendinosis', American Family Physician, 80(5), pp. 470–476.