What is bicep tendonitis?

Bicep tendonitis (bicipital tendonitis) 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.

As tendinitis progresses, the tendon becomes inflamed and thickens. The tendon can split or tear all the way across which then causes pain and a deformity in the upper arm (pop eye deformity).

Bicep tendonitis usually occurs along with other shoulder problems. In most cases, there is also damage to the rotator cuff tendons.

What causes bicep tendonitis?

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.

What are bicep tendonitis symptoms?

Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis. It is often made worse by overhead activity or lifting.

The pain and achiness can often move down the arm.

What is bicep tendonitis treatment?

Non-surgical methods are trialed firstly. This can include pain relief, activity modification, physiotherapy and steroid injections into the area around the tendon.

If your condition does not improve with these measures, surgical options exist. Surgery may also be an option if you have other shoulder problems.

Surgery for biceps tendinitis is usually performed arthroscopically. This allows your doctor to assess the condition of the biceps tendon as well as other structures in the shoulder.

The surgical options are dependent on the state of the tendon, its quality and your functional demands. Two broad options exist.

Firstly, if the tendon is very damaged then a release is done. This is minor procedure that relieves pain and discomfort and requires minimal rehabilitation afterwards allowing you to return to usual activities. However, this procedure can result in a cosmetic deformity in the upper arm, which may or may not be of significance.

Secondly, if the tendon is of better quality, a tenodesis can be performed. This is where the damaged section of the biceps is removed, and the remaining tendon is reattached to the upper arm bone (humerus). Removing the painful part of the biceps usually resolves symptoms and restores normal function.

Depending on your situation, your Melbourne Arm Clinic shoulder surgeon may choose to do this procedure arthroscopically or through a mini-open incision.