Biceps tendinitis

Why does my shoulder hurt?  I haven’t done anything different.  As your Woodbridge, Dale City VA Chiropractor I hear this a few times a month.  Another one is I can reach into my backseat anymore because my shoulder hurts.  Trust me, I know all the complaints since I get this every year or so.  Oddly enough like most Doctors when it is your injury it has to be different, you lose all diagnostic skill and it has to be worse than anyone else’s.  So, I catch myself on the phone to my orthopedic, neurology and chiropractic buddies going “man my shoulder is killing me, what do you think it is?”  That gets the long pause…  but I am quick to remind them “hey weren’t you in here all baffled with your SI pain a few weeks ago!”  Most times this unexplained but very painful complaint is biceps tendinitis.  And yes, it comes from regular movements.


Biceps Tendinitis

Biceps tendinitis is an inflammation or irritation of the upper biceps tendon. Also called the long head of the biceps tendon, this strong, cord-like structure connects the biceps muscle to the bones in the shoulder.

Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis. They can often be relieved with rest and medication. In severe cases, surgery may be needed to repair the tendon.



Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).


Biceps tendons

The biceps tendons attach the biceps muscle to the shoulder bone.

Glenoid. The head of your upper arm bone fits into the rounded socket in your shoulder blade. This socket is called the glenoid. The glenoid is lined with soft cartilage called the labrum. This tissue helps the head of the upper arm fit into the shoulder socket.

Rotator cuff. A combination of muscles and tendons keeps your arm centered in your shoulder socket. These tissues are called the rotator cuff. They cover the head of your upper arm bone and attach it to your shoulder blade.

Biceps tendons. The biceps muscle is in the front of your upper arm. It has two tendons that attach it to bones in the shoulder. The long head attaches to the top of the shoulder socket (glenoid).

The short head of the biceps tendon attaches to a bump on the shoulder blade called the coracoid process.



Biceps tendinitis is inflammation of the long head of the biceps tendon. In its early stages, the tendon becomes red and swollen. As tendinitis develops, the tendon sheath (covering) can thicken. The tendon itself often thickens or grows larger.

The tendon in these late stages is often dark red in color due to the inflammation. Occasionally, the damage to the tendon can result in a tendon tear, and then deformity of the arm (a “Popeye” bulge in the upper arm).

Biceps tendinitis usually occurs along with other shoulder problems. In most cases, there is also damage to the rotator cuff tendon. Other problems that often accompany biceps tendinitis include:


Arthritis of the shoulder joint

Tears in the glenoid labrum

Chronic shoulder instability (dislocation)

Shoulder impingement

Other diseases that cause inflammation of the shoulder joint lining



In most cases, damage to the biceps tendon is due to a lifetime of normal activities. As we age, our tendons slowly weaken with everyday wear and tear. This degeneration can be worsened by overuse — repeating the same shoulder motions again and again.

Many jobs and routine chores can cause overuse damage. Sports activities — particularly those that require repetitive overhead motion, such as swimming, tennis, and baseball — can also put people at risk for biceps tendinitis.

Repetitive overhead motion may play a part in other shoulder problems that occur with biceps tendinitis. Rotator cuff tears, osteoarthritis, and chronic shoulder instability are often caused by overuse.



Pain or tenderness in the front of the shoulder, which worsens with overhead lifting or activity

Pain or achiness that moves down the upper arm bone

An occasional snapping sound or sensation in the shoulder


Nonsurgical Treatment

Biceps tendinitis is typically first treated with simple methods.

Rest. The first step toward recovery is to avoid activities that cause pain.

Ice. Apply cold packs for 20 minutes at a time, several times a day, to keep swelling down. Do not apply ice directly to the skin.

Nonsteroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling.

Steroid injections. Steroids such as cortisone are very effective anti-inflammatory medicines. Injecting steroids into the tendon can relieve pain. Your doctor will use these cautiously. In rare circumstances, steroid injections can further weaken the already injured tendon, causing it to tear.

Chiropractic/Physical therapy. Specific stretching and strengthening exercises can help restore range of motion and strengthen your shoulder.





Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link