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Biceps Tendonitis and Tendon Tears

What is the Biceps Tendon?


The biceps muscle has two tendons at the shoulder: the long head (which attaches inside the shoulder joint to the labrum) and the short head (which attaches outside the joint). The long head tendon is most often involved in shoulder problems.


What is This Condition?


  • Biceps tendonitis is irritation and inflammation of the tendon, often causing pain in the front of the shoulder.

  • Partial tears mean the tendon is frayed but still attached.

  • Complete tears mean the tendon has fully torn, sometimes creating a “Popeye” bulge in the arm.


What Causes It?


  • Overuse, especially overhead lifting or throwing

  • Age-related wear-and-tear

  • Rotator cuff problems, which often occur together

  • Sudden heavy lifting or trauma


What are the Symptoms?


  • Pain in the front of the shoulder, especially with lifting or overhead use

  • Tenderness over the biceps tendon

  • Weakness in lifting or rotating the arm

  • A snapping or popping sensation in some cases

  • “Popeye” deformity (bulging of the biceps) if the tendon fully tears


How is It Diagnosed?


  • Exam: tenderness in the front of the shoulder, pain with resisted bending of the elbow

  • MRI or ultrasound: to confirm inflammation or tearing


How is It Treated?


Non-surgical:


  • Rest and activity changes

  • NSAIDs for pain

  • Physical therapy for shoulder and arm strengthening

  • Cortisone injections around the tendon


Surgical:


  • Tenotomy: releasing the tendon

  • Tenodesis: reattaching the tendon to the humerus


Learn more from AAOS (OrthoInfo):

– https://orthoinfo.aaos.org/en/diseases--conditions/biceps-tendinitis/

– https://orthoinfo.aaos.org/en/diseases--conditions/biceps-tendon-tear-at-the-shoulder/

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