Biceps Tendinopathy

Biceps tendinopathy is a condition that affects the tendon of the biceps muscle where it attaches inside the shoulder. The biceps muscle has two tendons at the shoulder: the short head, which attaches to the shoulder blade, and the long head, which travels through the shoulder joint before attaching to the top of the socket (the labrum). The long head tendon is prone to irritation and inflammation because it runs through a tight groove and passes inside the shoulder joint.

This tendon can become painful due to overuse, strain, or age-related changes. People often notice pain in the front of the shoulder that may spread down the upper arm. The pain is typically worse with lifting, overhead activities, or carrying objects. Although biceps tendinopathy can affect anyone, it is more common in people who do repetitive overhead work or sports such as swimming, tennis, or weightlifting.

Causes of Biceps Tendinopathy

Biceps tendinopathy usually develops from repeated use of the shoulder rather than a single injury. Common causes include:

Repetitive overhead activities such as throwing, swimming, or lifting weights
Shoulder impingement, which can pinch and irritate the tendon
Rotator cuff injuries that change the way the shoulder moves
Wear and tear with age that weakens the tendon over time

Signs and Symptoms if Biceps Tendinopathy

Typical symptoms of biceps tendinopathy include:

Pain or tenderness at the front of the shoulder that may spread down the arm
Pain with overhead movements, lifting, or carrying
Clicking or catching in the shoulder in some cases
Weakness when lifting or rotating the arm
Pain at night, especially when lying on the affected side

Diagnosis

When you see Mr Soong Chua for shoulder pain, he will begin with a careful examination of your shoulder and arm. He will check for tenderness over the biceps tendon, test your strength, and look for pain during certain movements.

If further information is needed, scans may be arranged. An ultrasound can show tendon irritation or inflammation, while an MRI can provide a more detailed picture and check for other shoulder conditions that may be contributing to your symptoms.

Non-Surgical Treatment

Most people with biceps tendinopathy improve without surgery. Non-surgical treatment may include:

Resting the shoulder and avoiding painful overhead activities
Ice and anti-inflammatory medication to reduce pain and swelling
Physiotherapy to stretch tight muscles, strengthen the shoulder, and improve posture and movement patterns
Cortisone injections in selected cases to reduce inflammation around the tendon

Surgery for Biceps Tendinopathy

If symptoms do not improve with non-surgical care, surgery may be recommended.

Mr Soong Chua performs Biceps Tendon Repair, where the damaged section of the tendon is either released or reattached to the upper arm bone. This takes the pressure off the inflamed tendon and helps restore comfortable movement and strength.

Surgery is usually done through keyhole techniques, sometimes combined with other procedures if there are associated shoulder problems such as rotator cuff tears or impingement.

Recovery involves a period of rest in a sling, followed by physiotherapy. Most people return to everyday activities within a few months, with full recovery for sport or heavy lifting taking longer.

Proximal (Long Head) Biceps Repair

FAQs

What causes biceps tendinopathy?
It is usually caused by repeated overhead use of the shoulder, such as in sports or manual work. It can also develop with age or be linked to other shoulder problems like impingement or rotator cuff tears.
How is biceps tendinopathy different from a biceps tear?
Tendinopathy refers to irritation and inflammation of the tendon, while a tear means the tendon has actually split or ruptured. Tendinopathy can progress to a tear if not treated.
Does biceps tendinopathy always need surgery?
No. Most people improve with non-surgical treatment such as rest, physiotherapy, and activity changes. Surgery is only considered if symptoms do not settle with these approaches.
How long does recovery take?
Recovery varies depending on the treatment. With non-surgical care, many people feel better within weeks to months. After surgery, it can take several months of rehabilitation before returning to full activity.
When should I see a surgeon?
If shoulder pain is persistent, affects your ability to work, play sport, or sleep comfortably, it is a good idea to see a specialist like Mr Soong Chua for an assessment and advice on treatment.