Neck & Shoulder

What It Is

Biceps tendonitis is an irritation or inflammation of the upper biceps tendon, also called the long head of the biceps tendon (AAOS, n.d.a). This strong, cord-like structure connects the upper end of the biceps muscle to the shoulder socket. Pain in the front of the shoulder and weakness when moving the shoulder are some of the common symptoms associated with biceps tendonitis. These problems can often be eased with rest and medication. In severe cases (e.g. when the tendon tears), surgery may be needed.

Research on tendons removed during surgery suggests that, in longer-standing cases, the problem is mainly wear and tear (degeneration) of the tendon rather than ongoing inflammation (Simon et al., 2022). Biceps tendonitis usually occurs along with other shoulder problems, such as rotator cuff wear or tears, arthritis of the shoulder joint, tears in the labrum (the rim of cartilage around the shoulder socket) or repeated dislocations (AAOS, n.d.a).

Biceps Tendonitis of the Shoulder Anatomy

The shoulder is a ball and socket joint. The socket is part of the shoulder blade, and the ball is the top of the upper arm bone. There are many muscles surrounding the shoulder which give the shoulder stability and strength.

The biceps muscle is found in the front of the upper arm. It helps to bend the elbow and turn the forearm, and also helps to steady the shoulder. To find the muscle, simply bend your arm and look for the bulge of the muscle contraction. The biceps muscle has two tendons that attach it to the shoulder blade. The long head attaches to the top of the shoulder socket (the glenoid), which is lined with soft cartilage that helps the head of the upper arm bone fit in the socket. The short head attaches to a bump on the front of the shoulder blade called the coracoid process (AAOS, n.d.a).

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

Treatment

Self-Care & Treatment

How to Treat Biceps Tendonitis of the Shoulder

Specific stretching and strengthening exercises can help restore your range of motion and strengthen the shoulder (AAOS, n.d.a). I can guide you on which exercises are right for you and when to start them, and use hands-on work to ease tension in the biceps and shoulder. See the My Approach tab for how I work.

1. Rest

The first step in treating biceps tendonitis is to avoid the activities that cause pain (AAOS, n.d.a). This condition is often linked to overuse, especially repeated overhead movements at work, in household chores or in sports such as swimming, tennis and baseball, so the cause is probably an activity you do often.

2. Ice

Apply a cold pack for up to 20 minutes at a time, several times a day, to help keep swelling down (AAOS, n.d.a). Never apply ice directly on the skin; wrap it in a cloth or towel first.

3. Anti-Inflammatory Medication

The American Academy of Orthopaedic Surgeons says that anti-inflammatory medicines such as ibuprofen and naproxen can reduce pain and swelling in biceps tendinitis (AAOS, n.d.a). (This medicine information comes from the American Academy of Orthopaedic Surgeons (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

Steroid (cortisone) injection: an injection of a strong anti-inflammatory medicine that can relieve pain, although OrthoInfo advises that cortisone should generally not be used for tendinitis because it can increase the chance of the tendon rupturing, especially the biceps tendon (AAOS, n.d.b).
Scans: X-rays only show bone but may reveal other shoulder problems, while an MRI or ultrasound scan shows the biceps tendon in more detail (AAOS, n.d.a).
Surgery: if other treatment does not help, an operation, usually done through small keyhole cuts (arthroscopy), can repair, reattach or release the damaged part of the tendon (AAOS, n.d.a).

How I can help (see the My Approach tab)

Hands-on work for the shoulder, arm and upper back

Shoulder blade and strength exercises, built up gradually

A plan for getting back to lifting and sport

Tips

Avoid heavy weight training, such as heavy biceps curls with a dumbbell or barbell, while your shoulder is painful. Gradual strengthening, which I can guide you through, is part of recovery (AAOS, n.d.a; Raney et al., 2017).
Avoid overhead lifting. Lifting overhead puts more strain on a tendon that is already painful. Only lift within a range that is comfortable and causes minimal pain.
The most common symptom is pain or tenderness in the front of your shoulder, which gets worse with overhead lifting. Other symptoms can include pain when reaching behind you (for example, to put on a seatbelt or a coat), an ache that moves down the upper arm, and an occasional snapping sound or sensation in the shoulder (AAOS, n.d.a). Clicking or clunking sounds in the shoulder are very common, so tell me about any unusual noises and I'll check them as part of your assessment.
Stretching and strengthening exercises can help with healing, and with sport in future. So stick with your rehab program.

Treatment

My Approach

Biceps tendonitis usually comes from overuse and often goes along with other shoulder problems, so I look at the whole shoulder, not just the sore spot at the front. My aim is to settle the pain, take strain off the tendon, and rebuild strength in your shoulder and arm so you can get back to lifting, reaching and sport.

I start by assessing your shoulder, shoulder blade, neck and upper back: how they move, how strong they are, and which movements bring on your pain. I'll also ask about your work, chores and training, because the cause is usually something you do often.

Settling the Pain

Cutting back overhead lifting and heavy curls while keeping you as active as is comfortable
Hands-on work for the biceps, shoulder and upper back muscles, plus gentle mobilisation of the shoulder and upper back
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Gentle holds, such as pressing your arm into a wall and holding, which often ease pain
Taping to support the shoulder blade if it helps

Building Strength

Shoulder blade work, such as wall push-ups and rows, then rotator cuff strengthening
Rebuilding the biceps slowly, from light holds to lifting and lowering under control
Cross-fibre work on the tendon once it's less irritable, followed by stretching
A home programme, then gym-based progressions back to heavier lifting and overhead work when you're ready
A plan for flare-ups: a little discomfort during exercise is fine, but pain shouldn't rise at night, at rest or over the next 24 hours; if it does, we drop back to the last level that felt fine

Any work on the chest wall muscles is only with your informed consent and a written consent form. Work near the armpit is only with your informed consent.

If your arm suddenly feels weak, especially without much pain, the tendon may have torn: see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Early on, most people come in once or twice a week, then weekly, then less often as you manage more on your own, with a reassessment at about 4 to 6 weeks. Expect steady improvement over weeks to months; long-standing tendon pain can take around six months to settle.

What I Focus On

Assessment

Shoulder & Arm Release

Shoulder Blade Control

Progressive Strength

Flare-Up Plan

Sources

References

American Academy of Orthopaedic Surgeons (AAOS) (n.d.a) Biceps tendinitis. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/biceps-tendinitis/ (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (AAOS) (n.d.b) Cortisone shot (steroid injection). OrthoInfo. Available at: https://www.orthoinfo.org/en/treatment/cortisone-shot-steroid-injection/ (Accessed: 7 October 2026).
Raney, E.B., Thankam, F.G., Dilisio, M.F. and Agrawal, D.K. (2017) 'Pain and the pathogenesis of biceps tendinopathy', American Journal of Translational Research, 9(6), pp. 2668–2683. PMID: 28670360.
Simon, M.J.K., Yeoh, J., Nevin, J., Nimmo, M. and Regan, W.D. (2022) 'Histopathology of long head of biceps tendon removed during tenodesis demonstrates degenerative histopathology and not inflammatory changes', BMC Musculoskeletal Disorders, 23, 185. doi: 10.1186/s12891-022-05124-z

Massage therapy · Kitchener–WaterlooBiceps Tendonitis of the Shoulder

What It Is

Biceps Tendonitis of the Shoulder Anatomy

Self-Care & Treatment

How to Treat Biceps Tendonitis of the Shoulder

1. Rest

2. Ice

3. Anti-Inflammatory Medication

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

Tips

My Approach

Settling the Pain

Building Strength

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooBiceps Tendonitis of the Shoulder

What It Is

Biceps Tendonitis of the Shoulder Anatomy

Self-Care & Treatment

How to Treat Biceps Tendonitis of the Shoulder

1. Rest

2. Ice

3. Anti-Inflammatory Medication

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

Tips

My Approach

Settling the Pain

Building Strength

Typical Course

References

Related Conditions

Acromioclavicular Joint Sprain

Biceps Brachii Tendinopathy

Calcific Tendinopathy of the Shoulder

Glenohumeral Joint Osteoarthritis

Book a session