What Is Bicep Tendonitis? Symptoms, Causes, Diagnosis, and Treatment Explained
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is bicep tendonitis?
Bicep tendonitis is inflammation of the upper biceps tendon, the long head of the biceps tendon that connects the biceps muscle to the shoulder blade, though it can also occur at the elbow. It is an overuse injury that often results from repeated overhead motion, and it can also be caused by a sudden, serious load on the tendon. [1]
Key takeaways
Bicep tendonitis is inflammation of the tendon that links your bicep to your shoulder. The long head of the biceps tendon attaches the biceps muscle to the shoulder blade bone, and the condition can also occur at the elbow. [1]
It is an overuse injury tied to repeated overhead motion. Athletes such as baseball players, swimmers, tennis players, and golfers are at higher risk, and everyday wear and tear can also cause it. [1]
The hallmark symptom is pain in the front of the shoulder that worsens with activity or overhead movement, sometimes accompanied by a snapping sensation. [1] [2]
Treatment starts conservatively with rest, ice, NSAIDs, physical therapy, and steroid injections. Surgery is reserved for persistent cases and is usually performed arthroscopically. [1] [2]
Recovery takes a few weeks with nonsurgical care, or three to four months after surgery. Most people who have surgery regain full range of motion and move their arm without pain. [1] [2]
What the research says
Two common surgeries gave similar function, but one more often left a "Popeye" bulge. In a randomized trial, 69 patients over 40 with a supraspinatus tear and a long head of the biceps tendon lesion were assigned to arthroscopic tenotomy or tenodesis during rotator cuff repair; 55 (31 tenotomy, 24 tenodesis) were evaluated at 6 and 24 months. There were no significant differences in Constant-Murley score, quality of life, pain, or strength, but the Popeye sign was more common after tenotomy at both time points. (Castricini et al., Knee Surg Sports Traumatol Arthrosc, 2018) [6]
Satisfaction is high after either surgery, with more side effects after tenotomy. In a retrospective single-surgeon cohort followed more than 2 years, 96% of tenodesis patients and 91% of tenotomy patients were satisfied or very satisfied. At least one downside (such as cramping, biceps pain, or a cosmetic deformity) was reported by 59% of tenotomy patients versus 37% of tenodesis patients, and 31% versus 16% reported multiple downsides. Because it was retrospective, results should be read with caution. (Aflatooni et al., J Orthop Surg Res, 2020) [7]
What Is Bicep Tendonitis?
Bicep tendonitis is a condition that occurs when you have inflammation in your upper biceps tendon. This tendon, also known as the long head of the biceps tendon, connects your biceps muscle to your shoulder blade bone. The condition can also occur at your elbow. [1]
A tendon is the tough band of tissue that anchors muscle to bone. [3] When that band becomes irritated and inflamed from repeated strain, the result is tendonitis, sometimes spelled tendinitis.
This type of tendonitis is an overuse injury that often happens due to a repeated overhead motion. Professional baseball players, swimmers, tennis players, and golfers are all at risk for tendonitis in their shoulders, arms, and elbows. Tendonitis can also occur because of a sudden, serious load to the tendon. [1]
Where it develops
Biceps tendonitis can occur at the long head of the biceps tendon at the shoulder or at the elbow. [1] It is worth knowing how the bicep connects at each end, because the two attachments behave differently when injured.
Conditions that often appear together
Biceps tendinitis does not typically occur alone. It most often happens alongside other shoulder issues, including: [1] [5]
Related condition | How it connects |
Shoulder arthritis | Joint wear that increases strain on surrounding tendons |
Dislocated shoulder | Instability that alters how the tendon glides through the joint |
Shoulder impingement syndrome | The rotator cuff area compresses, irritating the biceps tendon |
Symptoms of Bicep Tendonitis
If you have biceps tendonitis, you will have bicep pain or tenderness in the area in front of your shoulder. [5] This pain may get worse if you continue to participate in physical activity or try to lift your arm over your head. [1]
You may also have upper arm muscle pain that moves down your upper arm bone. [5] Along with pain and tenderness, you may hear a snapping sound or feel a snapping sensation in your shoulder. [1] [2]
Symptoms at a glance
What Causes Bicep Tendonitis?
Biceps tendonitis can happen with the wear and tear that you put on your tendons during your usual daily activities. As you get older, these tendons start to wear down, and they can get worse when you overuse them. When you use the same shoulder motions over and over again, the repeated wear and tear can lead to the condition. [1] [2]
Biceps tendonitis frequently affects athletes because of the repeated overhead motions they make in their sports. Baseball players, tennis players, golfers, and swimmers are particularly at risk of developing the condition. [1]
Risk factors
Risk factor | Why it matters |
Age | Tendons naturally wear down over time [1] |
Repeated overhead motions | Daily activities that repeat shoulder motion build up wear and tear [1] |
Sports and physical activities | Overhead sports load the tendon repeatedly [1] |
Arthritis | Joint changes increase tendon strain |
Smoking | Associated with poorer tendon health and healing |
Complications: biceps tendon tears
Severe overuse of your biceps tendons can lead to complications, including biceps tears. [1]
In cases of serious or constant overuse, a tendon may fray and eventually cause a bicep tear. A tendon can also tear as part of an injury, such as moving or twisting your elbow or shoulder in an awkward way, or falling down with your arm outstretched. At the elbow, the bicep tendon most often tears while lifting a heavy object, for example a couch or a refrigerator. [1]
A bicep tendon tear can happen at either the shoulder or the elbow. A tear can also be complete, known as a biceps tendon rupture, meaning the tendon has torn away from the bone, or partial. [1]
Tears of the distal biceps tendon at the elbow are unusual and most often result from an injury or lifting a heavy object. When this tendon tears, however, the tear is usually complete and the muscle separates from the bone and retracts back. This causes weakness in powerful palm-up activities, like tightening a screwdriver with the right hand. [1]
How Is Bicep Tendonitis Diagnosed?
Your healthcare provider will ask about your medical history and symptoms. Then, they will perform a physical exam. [1]
During the exam, your provider will check the function of your biceps. They will also check your shoulder for range of motion, strength, and signs of instability. [1] [2]
Diagnostic tests
Test | What it shows |
X-rays | Bone structure and joint changes; can reveal related shoulder issues |
Ultrasound | Real-time view of the tendon for inflammation or tearing |
MRI (magnetic resonance imaging) | Detailed images of soft tissue, including the tendon and surrounding structures [2] |
How Is Bicep Tendonitis Treated?
Treatment for biceps tendonitis typically starts with noninvasive, nonsurgical methods. If these do not improve your condition, your healthcare provider may suggest surgery. [1] [2] [5]
Nonsurgical treatment
Method | What it does |
Cold packs | Ice or cold packs reduce swelling and pain [1] |
NSAIDs | |
Rest | Avoid heavy lifting, flexing at the elbow, and overhead movements [1] |
Physical therapy | A physical therapist guides recovery with biceps tendonitis exercises [1] |
Steroid injections | A corticosteroid can relieve pain, halt the inflammatory process, and help the tendon heal [1] |
Surgical treatment
If noninvasive methods do not help improve your condition, your provider may suggest surgery. The procedure is usually performed arthroscopically, meaning the surgeon inserts a small camera, called an arthroscope, into the shoulder joint to take pictures, which helps guide the procedure using small surgical instruments. [1]
Possible surgical complications
Overall, complication rates from surgery for biceps tendonitis are low. But surgery can sometimes lead to complications, including infection and bleeding at the surgical site, stiffness, bicep pain, muscle spasms, and a cosmetic "Popeye" deformity, which is a bulge in your arm. [1]
How Long Does Bicep Tendonitis Take to Heal?
Recovery time depends on the extent of your injury and the method of treatment. With noninvasive treatment, your condition should improve within a few weeks. [1]
If you have surgery, recovery time will take longer. Your provider will recommend wearing a sling anywhere from one to four weeks, depending on the surgery. You will also need physical therapy or some other form of rehabilitation. It may take three to four months for full recovery. [1] [5]
Recovery timeline at a glance
Outlook and Prognosis
If you have biceps tendonitis, you will feel pain and tenderness in your shoulder area. If simple measures like rest, pain relievers, and ice do not help improve your condition within a few weeks, your provider may recommend surgery. [1]
Most people who get surgery for biceps tendonitis have good results. You should be able to regain your full range of motion and move your arm without pain. If you play sports with lots of overhead motions, you may need to limit your activities after surgery. [1] [2]
Can Bicep Tendonitis Be Prevented?
Because overuse causes most cases of tendonitis, the best treatment is prevention. It is important to avoid or change the activities that cause the problem. [1]
When doing physical activities, take it slowly at first and gradually build up your activity level. Limit the number of repetitions you do and the amount of force you use. Stop if you feel any unusual pain. [1]
Be careful to avoid and then correct improper posture or poor technique in sports or work. [1]
Prevention tips at a glance
Strategy | Practical application |
Build up gradually | Take it slowly at first and increase activity level step by step [1] |
Control load | Limit repetitions and the amount of force you use [1] |
Listen to your body | Stop if you feel any unusual pain [1] |
Check technique | Correct improper posture or poor form in sports and work [1] |
Living With Bicep Tendonitis
When to see a healthcare provider
Many cases of biceps tendonitis will go away within a few weeks of simple measures, including rest, ice, and NSAIDs. But if your pain makes it difficult to perform your usual daily activities and self-care has not improved your condition, you should see your healthcare provider for further treatment. [1]
You should also see your provider if pain continues to interfere with overhead motions you make while playing sports. Call your provider if you experience any sharp, sudden pains or develop a bulge in your upper arm. [1]
Questions to ask your provider
What kind of treatment do you recommend?
What else can I do for the pain?
When can I return to my usual activities?
How can I prevent this condition in the future?
Conclusion
Bicep tendonitis is inflammation of the long head of the biceps tendon, the cord anchoring your bicep muscle to your shoulder blade. It is fundamentally an overuse injury, driven by repeated overhead motions in sports like baseball, tennis, golf, and swimming, as well as by the everyday wear and tear that accelerates with age.
The hallmark signs are pain and tenderness in the front of the shoulder, discomfort that worsens with activity or overhead movement, and sometimes a snapping sensation. Left untreated, severe overuse can progress to a tendon tear, including a complete rupture. Diagnosis combines a physical exam with imaging such as X-rays, ultrasound, or MRI. Treatment begins conservatively with rest, ice, NSAIDs, physical therapy, and steroid injections, and moves to arthroscopic procedures like tenodesis or tenotomy only when needed. Most people recover within a few weeks of nonsurgical care, and surgery patients typically regain full range of motion within three to four months.
If your shoulder pain lingers despite rest and ice, the smart move is an evaluation from a healthcare provider, before a minor irritation becomes a tear.
Turn musculoskeletal content into clear, shareable visuals. If you explain injury and recovery topics to patients, teams, or readers, Rinnit's library of infographic templates can help you illustrate conditions like bicep tendonitis in minutes, no design experience required.
Frequently Asked Questions
What is bicep tendonitis?
Bicep tendonitis is a condition that occurs when you have inflammation in your upper biceps tendon. This tendon, the long head of the biceps tendon, connects your biceps muscle to your shoulder blade bone. The condition can also occur at your elbow. [1]
Is bicep tendonitis an overuse injury?
Yes. This type of tendonitis is an overuse injury that often happens due to a repeated overhead motion. It can also occur because of a sudden, serious load to the tendon. [1]
Who is most at risk?
Biceps tendonitis frequently affects athletes because of repeated overhead motions in their sports. Baseball players, tennis players, golfers, and swimmers are particularly at risk. Risk factors also include age, arthritis, and smoking. [1]
Can everyday activities cause it?
Yes. Biceps tendonitis can happen with the wear and tear you put on your tendons during usual daily activities. As you get older, these tendons wear down and worsen with overuse, and repeating the same shoulder motions builds up the damage. [1]
What does bicep tendonitis feel like?
You will have bicep pain or tenderness in the area in front of your shoulder. The pain may worsen with continued physical activity or when lifting your arm over your head. You may also feel upper arm muscle pain moving down the upper arm bone, and hear or feel a snapping sensation in your shoulder. [1]
Does bicep tendonitis happen on its own?
Biceps tendinitis does not typically occur alone. It most often happens alongside other shoulder issues, including shoulder arthritis, dislocated shoulder, and shoulder impingement syndrome. [1]
Can bicep tendonitis lead to a tendon tear?
Yes. Severe overuse can cause the tendon to fray and eventually tear. A tear can also result from an injury, such as twisting the elbow or shoulder awkwardly, falling with an outstretched arm, or lifting a heavy object at the elbow. [1]
What is a biceps tendon rupture?
A biceps tendon rupture is a complete tear in which the tendon has torn away from the bone. Tears can also be partial, and they can occur at either the shoulder or the elbow. [1]
Why do distal biceps tears cause so much weakness?
Only one tendon attaches the biceps to the elbow, and when it tears, the tear is usually complete and the muscle separates from the bone and retracts back. [1] This causes weakness in powerful palm-up activities like tightening a screwdriver with the right hand. [1]
How is bicep tendonitis diagnosed?
A provider takes your medical history, asks about symptoms, and performs a physical exam that checks biceps function, shoulder range of motion, strength, and signs of instability. Imaging tests may include X-rays, ultrasound, and MRI. [1] [2]
How is bicep tendonitis treated?
Treatment typically starts with noninvasive methods: cold packs to reduce swelling and pain, NSAIDs like aspirin or ibuprofen, rest from heavy lifting and overhead motion, physical therapy exercises, and corticosteroid injections to halt inflammation and support healing. [1]
When is surgery needed?
If noninvasive methods do not help improve your condition, your provider may suggest surgery, usually performed arthroscopically with a small camera guiding the procedure through small surgical instruments. [1]
What surgical options exist?
The two main options are biceps tenodesis, in which the damaged section of the bicep is removed and the remaining tendon is reattached to the humerus, and tenotomy, in which the damaged tendon is released from its attachment. [1] [2]
Are there risks to surgery?
Complication rates are low overall, but surgery can sometimes cause infection or bleeding at the surgical site, stiffness, bicep pain, muscle spasms, and a cosmetic "Popeye" deformity, a bulge in the arm. [1]
How long does recovery take?
With noninvasive treatment, your condition should improve within a few weeks. After surgery, expect to wear a sling for one to four weeks, complete physical therapy or rehabilitation, and allow three to four months for full recovery. [1]
What is the outlook after surgery?
Most people who get surgery for biceps tendonitis have good results. You should be able to regain full range of motion and move your arm without pain, though you may need to limit sports with lots of overhead motions afterward. [1] [2]
Can bicep tendonitis be prevented?
Since overuse causes most cases, prevention is the best treatment. Build activity up gradually, limit repetitions and force, stop when you feel unusual pain, and avoid or correct improper posture and poor technique in sports or work. [1]
When should I see a healthcare provider?
See your provider if pain makes daily activities difficult and self-care has not helped, if pain interferes with overhead motions in sports, or if you experience sharp, sudden pains or develop a bulge in your upper arm. [1]
What questions should I ask my provider?
Useful questions include what kind of treatment they recommend, what else you can do for the pain, when you can return to your usual activities, and how to prevent the condition in the future.
Related Reading
References
Cleveland Clinic. Bicep Tendonitis. Cleveland Clinic Health Library. Last updated March 25, 2024. Accessed October 15, 2026. https://my.clevelandclinic.org/health/diseases/bicep-tendonitis
Stoll LE, Aibinder WR; peer-reviewed by Throckmorton TW. Biceps tendinitis. OrthoInfo, American Academy of Orthopaedic Surgeons. Accessed October 15, 2026. https://www.orthoinfo.org/diseases--conditions/biceps-tendinitis/
American College of Rheumatology. Tendinitis (Bursitis). ACR Patient Resources. Last updated February 2025. Accessed October 15, 2026. https://rheumatology.org/patients/tendinitis-bursitis
Hsu D, Anand P, Mabrouk A, et al. Biceps tendon rupture. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jul 15. PMID 30020607. https://www.ncbi.nlm.nih.gov/books/NBK513235/
Varacallo MA, Mair SD. Proximal biceps tendinitis and tendinopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Aug 4. PMID 30422594. https://www.ncbi.nlm.nih.gov/books/NBK533002/
Castricini R, Familiari F, De Gori M, et al. Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions. Knee Surg Sports Traumatol Arthrosc. 2018;26(1):169-175. PMID 28623414. https://doi.org/10.1007/s00167-017-4609-4
Aflatooni JO, Meeks BD, Froehle AW, et al. Biceps tenotomy versus tenodesis: patient-reported outcomes and satisfaction. J Orthop Surg Res. 2020;15(1):56. PMID 32070381. https://doi.org/10.1186/s13018-020-1581-3
Medical disclaimer
The information provided in this article is for educational purposes only and is not intended as medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you experience sharp, sudden pain or develop a bulge in your upper arm, contact your healthcare provider promptly.
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