Biceps Tendonitis

The biceps tendon attaches the biceps muscle to the shoulder proximally and to the elbow distally.  At the shoulder the biceps tendon splits into two heads called the long and short heads. Injury to the long head is the most common type of biceps tendon injury and a common source of shoulder pain that may require surgical intervention when nonsurgical treatment fails.

What are biceps tendinitis and tendinosis?

Biceps Tendinitis is inflammation or irritation of the long head of the biceps tendon that causes microtears in the tendon.  Biceps tendinosis is caused by degeneration of the tendon due to activities that require overhead motion, lifting heavy loads, falls on an outstretched arms or from the normal aging process. Tendinitis and tendinosis can be accompanied by a rotator cuff tear.

What are the symptoms of biceps tendinitis?

  • A deep, throbbing ache, pain and tenderness in the front of the shoulder that can be aggravated with overhead activity and lifting.

  • Pain or discomfort that travels down the upper arm.

  • Sometimes there may be a shoulder sensation or snapping sound.

How is biceps tendinitis diagnosed?

Dr. Johnston will review your medical history, ask questions about your symptoms and conduct

an assessment of the shoulder range of motion, strength and stability of your shoulder. In addition, he will test the function of your biceps muscles.

X-rays may be ordered to evaluate the bones in your shoulder and an MRI may be ordered so Dr. Johnston can visualize the soft tissues.

How is biceps tendinitis treated?

First line treatment is conservative focused on rest, icing, over the counter anti-inflammatory medications, activity modification and physical therapy. Tendinitis may resolve with conservative treatment but could take up to a year. If needed, steroid injections can reduce inflammation and relieve pain.

When symptoms fail to improve, and interfere with sleep, dressing and doing a job, Dr. Johnston may recommend a minimally invasive surgical procedure to view the tendon directly and assess its condition along with evaluating other shoulder structures that could be involved. If you also have a rotator cuff tear or other tendon damage surgery will be recommended. The surgical procedure is called biceps tenodesis.