Neck & Shoulder

What It Is

The biceps muscle is located in the front of your upper arm. It helps you to bend the elbow and rotate the arm. Tendons keep the muscle attached to the bones. The biceps tendons attach the biceps to the bones at the elbow and the shoulder. If the biceps tendon tears at the shoulder, you may lose some strength in your arm and have pain when you forcefully turn your arm from palm down to palm up (AAOS, n.d.). Most people need only simple treatments to relieve their symptoms and can still function well with a tear at the shoulder, because the biceps has two attachments at the shoulder and a tear usually involves only one (AAOS, n.d.). Surgery is rarely needed (AAOS, n.d.).

Biceps Tendon Tear at the Shoulder Anatomy

The shoulder is a ball-and-socket joint made up of three bones: the upper arm bone (humerus), the collarbone (clavicle) and the shoulder blade (scapula). The head (ball) of the upper arm bone fits into a rounded socket in the shoulder blade. A combination of muscles and tendons keeps the ball centred in the socket. These tissues are called the rotator cuff; they cover the head of the upper arm bone and attach it to the shoulder blade (AAOS, n.d.).

The upper part of the biceps muscle has two tendons that attach it to the bones of the shoulder. The long head attaches to the top of the shoulder socket, while the short head attaches to a bump on the shoulder blade (the coracoid process) (AAOS, n.d.). The long head is the one most likely to tear (AAOS, n.d.).

If the long head tears completely, you may see a bulge in your upper arm above the elbow (sometimes called a "Popeye" muscle), bruising down the upper arm, and cramping of the biceps when you use your arm hard (AAOS, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Biceps Tendon Tear at the Shoulder

Flexibility and strengthening exercises help to restore movement and strengthen the shoulder (AAOS, n.d.). I can help with hands-on work around the shoulder and arm, stretching and a strengthening programme. See the My Approach tab for how I work.

This injury normally takes about six weeks to heal, but symptoms can continue for up to three months (Whittington Health NHS Trust, 2022). For most people, the pain goes away over time (AAOS, n.d.).

1. Rest

Try to rest your shoulder for the first 24 to 72 hours, and avoid heavy lifting and overhead activities to limit swelling and pain. A sling may be used for comfort for a short time, but you should stop using it as soon as possible. After this, it is important to keep your shoulder moving to prevent stiffness (Whittington Health NHS Trust, 2022; AAOS, n.d.).

2. Ice

Use an ice pack or a bag of frozen peas wrapped in a damp towel on your shoulder for up to 15 minutes every few hours. Make sure the ice is not in direct contact with your skin (Whittington Health NHS Trust, 2022).

3. Anti-Inflammatory Medications

AAOS (n.d.) says anti-inflammatory medicines such as ibuprofen or naproxen can reduce pain and swelling from a biceps tendon tear at the shoulder. (This medicine information comes from AAOS OrthoInfo, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

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

Options outside my scope

Scans: an ultrasound or MRI scan can check the tendon and look for other shoulder problems, such as rotator cuff injuries (AAOS, n.d.).
Surgery: this is rarely needed for a tear of the long head. It may be considered if other treatment has not helped, if you have severe cramping in the biceps, or if weakness stops you working or doing daily activities. The torn tendon is usually reattached to the upper arm bone (AAOS, n.d.). If you have surgery, follow your surgical team's own instructions.

How I can help (see the My Approach tab)

Hands-on work for the shoulder, arm and neck
Stretching and a strengthening programme for the shoulder and arm
Advice on lifting and overhead work
Rehab support after surgery, once your surgical team clears it

Tips

Older people have put a lot more wear and tear on their tendons than younger people (AAOS, n.d.).
Many tears happen because the tendon gradually wears down and frays over time, which is more common than a tear from a single injury. A worn tendon can then tear, for example when lifting something heavy or falling on an outstretched arm (AAOS, n.d.).
Minimising heavy overhead activities is beneficial to your shoulder. Too much weight when weightlifting, and jobs that involve heavy overhead lifting, can cause extra wear and tear on the tendons (AAOS, n.d.).
Smoking can weaken tendons (AAOS, n.d.).
Corticosteroid medicines have been linked to muscle and tendon weakness (AAOS, n.d.). Do not stop any prescribed medicine without talking to your doctor.
Repeated overhead use of the shoulder can lead to other problems, such as tendinitis, bursitis, shoulder impingement and rotator cuff injuries, which put more stress on the biceps tendon (AAOS, n.d.).

Treatment

My Approach

Most tears of the long head of the biceps settle without surgery, and the arm usually still works well because the biceps has a second attachment at the shoulder. Your family doctor or nurse practitioner, or your surgeon, leads the medical side, and I support it by easing pain, keeping the shoulder moving and rebuilding strength. If you've had surgery, I follow your surgical team's protocol and need their okay before we start any hands-on treatment.

I start by assessing how your shoulder, elbow and neck move, testing your strength, and asking about your work, training and what brings the pain on.

Early On

Gentle hands-on work for the shoulder, upper arm, neck and upper back, which often tense up to protect the arm
Gentle lymphatic drainage to help with swelling and bruising down the arm
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Gentle, pain-free movement for the shoulder, elbow and hand so nothing stiffens up

As It Settles

Myofascial and trigger point work for the biceps, shoulder and forearm, with gentle stretching for the arm and shoulder
Scar work once any incision has fully healed, if you had surgery
Strengthening for the shoulder, shoulder blade and arm, starting light and building gradually
A home programme to do between visits

Back to Lifting and Work

A graded return to work, sport or the gym, building the load step by step
Help with lifting technique and sensible loading, drawing on my years working with powerlifters, so heavy or overhead lifting doesn't keep straining the tendon

If you notice a new bulge in your upper arm, sudden weakness or cramping that keeps getting worse, see your family doctor or nurse practitioner so it can be checked.

What to Expect

Typical Course

Typical course: Early on, visits are usually once or twice a week, then weekly, then spaced out as you manage more with your home programme, with a reassessment at about 4 to 6 weeks. This injury usually takes about six weeks to heal, although symptoms can carry on for up to three months; if you've had surgery, the timeline follows your surgical team's plan.

What I Focus On

Pain Relief

Compensation Relief

Shoulder Mobility

Progressive Strength

Return to Lifting

Sources

References

American Academy of Orthopaedic Surgeons (AAOS) (n.d.) Biceps tendon tear at the shoulder. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/biceps-tendon-tear-at-the-shoulder/ (Accessed: 7 October 2026).
Whittington Health NHS Trust (2022) Long head of biceps injury. Patient information leaflet. Available at: https://whittington.nhs.uk/document.ashx?id=14949 (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooBiceps Tendon Tear at the Shoulder

What It Is

Biceps Tendon Tear at the Shoulder Anatomy

Self-Care & Treatment

How to Treat Biceps Tendon Tear at the Shoulder

1. Rest

2. Ice

3. Anti-Inflammatory Medications

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

Tips

My Approach

Early On

As It Settles

Back to Lifting and Work

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooBiceps Tendon Tear at the Shoulder

What It Is

Biceps Tendon Tear at the Shoulder Anatomy

Self-Care & Treatment

How to Treat Biceps Tendon Tear at the Shoulder

1. Rest

2. Ice

3. Anti-Inflammatory Medications

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

Tips

My Approach

Early On

As It Settles

Back to Lifting and Work

Typical Course

References

Related Conditions

Biceps Tendon Tear at the Elbow

Glenoid Labrum Tear

Shoulder Labral Tear

SLAP Tear (Superior Labrum Anterior to Posterior)

Book a session