Bicep Tendonitis: What Causes The Pain and How To Fix It

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We use our arms for nearly everything, and considering the high mileage and amount of stress we put on them it’s no wonder that we may experience pain in our arms from time to time.

One type of pain in our arm could be caused by bicep tendonitis, which is also called bicep tendinopathy or bicep tendinitis. 

Bicep tendonitis is when one of our bicep tendons becomes inflamed and irritated. It mainly affects the long head biceps tendon, but can also hit the distal bicep tendon, causing pain and joint stiffness.

“Tendonitis” refers to the inflammation that happens when the stress on a tendon exceeds its tolerance, which results in micro-tearing of the tendon. 

Luckily, it’s not usually an issue that needs heavy medical attention. Rather, you can take care of it by yourself!

Let’s dive deeper into what bicep tendonitis is, who’s at most risk, how it’s caused, what your symptoms may be, and how to fix it.

Anatomy 101

Everyone knows the bicep muscle — ask anyone to “flex” and they’ll most likely pose with their arm up in their best Arnold Schwarzenegger impression.

In fact, many workout programs focus on developing this muscle, like our guide on the fastest way to build your biceps with calisthenics, which requires minimal equipment. 

However, something that not everybody may know is that the bicep is actually a two-headed muscle. 

The latin term for biceps, biceps brachii, means “two-headed muscle of the arm,” and refers to the short head and the long head of the biceps.

Both of these share a common insertion point at the elbow on the radius, which is one of the two bones that make up the forearm. 

Their other insertion points are:

• Short Head — attaches to the coracoid process, a part of the shoulder blade under the acromion

• Long Head — attaches to the shoulder at the supraglenoid tubercle, which is right where the shoulder blade and the arm bone, or humerus, connect. From there, it travels through the intertubercular groove of the humerus — this’ll be important later!

 Function of the Biceps

There are two main functions that the biceps complete, both of which are important when it comes to moving our arm — with one bonus function:

• Supination — rotating your forearm outwards so that your palm faces up
• Elbow Flexion — bending at your elbow — like when you’re “flexing” your biceps
• Bonus: Stability — your bicep muscles have some weak influence with moving your shoulder around since the short and long heads attach there, but they actually help out with stabilizing the shoulder, especially when we carry heavier things with our arm down by our side

Let’s put all that into real-world terms: your biceps not only have the potential to be head-turners with their size, but they also help you carry groceries, carry a bowl of soup, and lift a bottle of water to your mouth.

Basically, they’re essential to living your day-to-day life with as few complications as possible.

So, there is obviously wisdom in keeping your biceps healthy. But what are some risk factors you can watch out for to help avoid any unnecessary pain?

Let’s find out.

Risk Factors

Risk factors for bicep tendonitis can be things that you can control or things that you can’t control.

Sometimes, there are aspects of your life that just put you in a tougher position when it comes to bicep tendonitis, and that’s ok — that’s life!

But there are definitely things you can change or at least watch out for to minimize the risk of developing this type of condition.

• Age — obviously this isn’t one you can avoid. Generally, the older you get, the more likely you are to develop tendon issues. After all, older adults have had a lot more years to put stress on their tendons than teenagers have
• Weight — excess weight forces the tendons and muscles to carry more load, resulting in more stress on them that can hurt them over time. Check out our nutrition guide to cut down the pounds and achieve your dream body!
• Repetitive Movement — this is a big one. Straining your tendons with repetitive movements such as racket sports, weight lifting, or certain jobs can cause those micro-tears in the tendon
• Smoking — I probably don’t have to convince you that smoking is bad for your health, but nicotine use has actually been shown to impact tendon strength and quality 
• Overhead Lifting — overhead movements can put more stress on the tendons, which may result in more micro-tearing and inflammation

As you can see, some of these risk factors can be minimized or even avoided completely. 

Let’s see how these tie-in with the causes of bicep tendonitis.

Causes of Bicep Tendonitis

Generally, bicep tendonitis can happen with anything that has the potential to cause micro-tears in the bicep tendons. 

This can come from general wear-and-tear, where years of use may eventually catch up to you and cause pain that seems to come from out of nowhere, without injury.

It can also be caused by repetitive motions through your shoulders and/or arms. 

You’ll find that if your job requires a lot of lifting or constant moving with certain positions, you may experience tendonitis more quickly than someone who doesn’t work in a repetitive job.

Lifting heavy weights that exceed the tolerance of the tendons, especially with bicep curls or overhead movements, can cause micro-tearing too. 

You want to be sure that your exercise plan is following a proper weight progression with good equipment, like our back and biceps workout using the Redge Fit.

Long-Head Biceps Tendon and the Intertubercular Groove

Since the long-head biceps tendon runs through a groove, it already has limited space. 

When the tendon is inflamed, it thickens up and becomes irritated. 

Now that space in the groove becomes even tighter, rubbing against the tendon more and more.

This creates a vicious cycle: 

• the tendon becomes inflamed and thickens
• it rubs against bone in the intertubercular groove
• it becomes even more irritated and the inflammation continues 
• the tendon stays thick 

and the cycle continues.

This sounds painful — and it often is!

Let’s see what the symptoms of bicep tendonitis are.

Symptoms of Bicep Tendonitis

The main symptoms that you may experience are:

• Pain — at the front of the shoulder or in the elbow that worsens with movement 
• Radiating Pain — radiates down the front of your arm
• Swelling — around the painful site
• Clicking or Snapping — in the shoulder
• Overhead Movements cause pain
• Insidious Pain — seemingly no incident where pain or injury may have happened
• Muscle Weakness — difficulties moving the shoulder or arm 
• Joint stiffness in the elbow or shoulder
• Difficulties rotating your forearm

These can be tough symptoms to deal with, but luckily there are several options to improve your biceps tendonitis!

Let’s check them out.

How To Fix Bicep Tendonitis

Usually we can fix this without surgery through the wonders of self-management and exercises. 

In fact, surgery is rarely needed, and usually only considered if there is no change in symptoms or function after 3 months, or if there is extreme damage to the tendon.

Since there is very little need for surgery with this type of condition, let’s focus on self-management and exercise techniques that we can use.

Bicep Tendonitis Self-Management

The silver-lining with bicep tendonitis is that self-management strategies often take care of a lot of the pain.

It’s important to note that what may work for one person, may not work as well for another person.

Different levels of intensity and irritation between people suffering from bicep tendonitis will influence how much of an effect these strategies have, as well as the time-frame needed to see any effects.

That being said, let’s talk about massage, rest, and ice/heat.

Massage

Massage should be used as something that relieves pain.

Some people like the deep tissue massages that leave them squirming on the massage table in agony — and these types of massage have their place!

However, with something like this where the body is irritated and has a tendon stuck in a cycle of inflammation, we want to take a more conservative approach.

Massage is great for relaxing different structures in the body, and creates increased blood flow in the target area.

This is exactly what we’re looking for — blood flow.

Doing this can help decrease pain and put the body in a better state for healing.

Now, going to the masseuse everyday isn’t the most practical (or cost effective) — luckily, we’ve created a list of great massage guns that you can find on Amazon that often cost less than a single massage session.

You can use these as much as is comfortable — don’t bang away at the pain site, this is not a “no pain no gain” type of situation.

Spending around 10 minutes working through the shoulder and bicep could help relax the muscles and tendons, and put some extra blood flow around those tendons to help decrease the pain.

Rest

I want to be clear here: you don’t need to go on bed rest to avoid any and all movement.

That is a bad idea 9.9 out 10 times.

Instead, we want to respect the movements that cause us pain. 

This may mean that you need to take a break from shoulder pressing heavy weights at the gym, or practicing tennis for 2 hours a day.

The idea is that we want to avoid the movements that cause irritation in the tendons — you’ll quickly find out what these are for you.

Again, we don’t want to completely avoid anything. That will just stiffen things up more for you.

Move within your tolerance levels.

Ice & Heat

The classic go-to with injuries: ice and heat.

Now, these can be used in conjunction with one another, and in my experience different people like different things. 

Ice tends to do better if your goal is to decrease swelling. It can also help with the pain — however, in this case it could also irritate things.

You see, tendonitis is different from a sprain (where ice often feels good), and it sometimes likes to have a focus on muscle relaxation and blood flow more so than trying to decrease swelling.

That’s where heat comes in.

Heat is great to promote blood flow and to have tightened structures such as muscles relax a bit. 

Consequently, it may be better at providing relief than ice would — again, sometimes trading them off every 10 minutes or so provides a good environment for pain relief, but it may take a little bit of experimenting.

Exercising for Bicep Tendonitis

I realize that exercising sounds like a bad idea — I did just say to avoid aggravating movements after all.

However, the trick is to find a couple of movements that feel OK to do and don’t further exacerbate your symptoms. 

Sometimes this simply means trading out exercises that bug you for ones that don’t.

For example, if having your arm overhead or having a lot of strain on your bicep like during a bicep curl bothers you, try doing something like a bodyweight row, which puts less strain on your biceps.

That being said, as you get stronger with movements that are more comfortable to do, you want to try challenging yourself in a slow and controlled manner. 

One way that you can do this is by focusing on eccentric movements.

These are movements where we lengthen our muscle rather than contract it. Our muscles are stronger with this type of movement, and has several benefits:

• Tendon Strengthening — our tendons adapt well to eccentric exercises, and love to be challenged in a way where they are lengthened rather than shortened during times of irritation
• Easy To Do — now I’m not referring to the exercise being easy. It can be made to be tough. But these types of movements don’t usually require a lot of equipment or spotters
• Easy To Progress — like I mentioned, these can be tough. The high progress potential of these exercises means you can start with easier movements and work your way to really tough exercises

To get a better understanding of how eccentric and concentric movements differ from each other, and what the benefits of each are, check out our guide to help catapult your rehab forward. 

Your goal should be to regain a pain-free range of motion, especially with overhead movements, and then progressively strengthening that range of motion.

Conclusion

Biceps tendonitis refers to inflammation in the long-head or short-head bicep tendons commonly caused by irritation from overuse, general wear-and-tear, or repetitive movements.

It’s characterized by pain in the front of the shoulder or the front of your arm, pain with movement (often overhead movements), and difficulties moving your arm due to pain and/or stiffness.

It usually takes a combined strategy of resting from aggravating movements and building up strength in a progressive way through the use of light stretching and exercises that feel comfortable for you to do, often by decreasing the weights you currently use at the gym or by following a workout program that you can do at home. 

That being said, we know what it’s like to be lost with where to begin — especially if most exercises cause you pain.
That’s why we want to offer you a free consultation call with a Certified Coach to help you set-up a program that you can do from anywhere, and take back control of your pain and body!