What Is Biceps Tendinitis?
Biceps tendinitis is inflammation of the biceps tendon — the thick cord of tissue that connects the biceps muscle to the shoulder joint. It typically affects the long head of the biceps tendon, which runs through a groove in the front of the shoulder and attaches inside the shoulder joint itself. The result is a deep, aching pain at the front of the shoulder and upper arm that worsens with overhead activity, lifting, or repetitive arm use.
At Pittsburgh Physical Medicine, we see biceps tendinitis regularly — especially in active adults, overhead athletes, manual laborers, and anyone who has been compensating for a previous shoulder injury.
Common Causes
Biceps tendinitis rarely develops in isolation. It usually develops alongside other shoulder problems, particularly:
- Rotator cuff dysfunction — when the rotator cuff is weak or injured, the biceps tendon takes on more load than it's designed to handle
- Shoulder impingement syndrome — the biceps tendon gets compressed under the acromion during overhead movement
- Repetitive overhead activity — throwing, swimming, tennis, CrossFit, or manual overhead work
- Sudden increases in training load — doing too much too fast without adequate conditioning
- Postural problems — forward head posture and rounded shoulders alter mechanics throughout the shoulder complex
Symptoms to Watch For
- Aching pain at the front of the shoulder, especially when lifting the arm
- Pain that radiates down the front of the upper arm
- Tenderness when pressing on the bicipital groove (the groove at the front of the shoulder)
- Pain with overhead reaching, pushing, or pulling
- A sensation of weakness in the arm or shoulder
- Occasionally, a popping or snapping feeling in the shoulder
Important: Biceps tendinitis that is left untreated can progress to a partial or complete biceps tendon tear — a much more serious injury. Early treatment produces significantly better outcomes.
How We Treat Biceps Tendinitis
Effective treatment of biceps tendinitis requires addressing both the inflamed tendon and the underlying shoulder mechanics causing the problem. At Pittsburgh Physical Medicine, our approach combines:
Chiropractic Care
Dr. Foltz and Dr. O'Mara assess the entire shoulder complex — including the AC joint, glenohumeral joint, cervical spine, and thoracic spine — to identify any biomechanical faults contributing to abnormal tendon loading. Adjustments restore proper joint mechanics and reduce compensatory muscle strain.
Graston Technique (IASTM)
Instrument-assisted soft tissue mobilization breaks down scar tissue and adhesions within the biceps tendon and surrounding musculature, improving tissue quality and reducing pain. Graston is one of the most effective conservative treatments for chronic tendon conditions.
Physical Therapy with Dr. Crockatt
Dr. Charlie Crockatt, DPT, designs a targeted rehabilitation program to restore rotator cuff strength, scapular stability, and shoulder mechanics. Properly rehabilitating the muscles that support the biceps tendon is essential to preventing recurrence.
Shockwave Therapy
For chronic or stubborn cases, extracorporeal shockwave therapy (ESWT) stimulates the body's natural healing response within the tendon, promoting tendon regeneration and reducing pain.
Recovery Timeline
Most patients with biceps tendinitis experience significant improvement within 4–8 weeks of consistent treatment. Chronic cases may take longer, particularly if there is significant tendon degeneration or coexisting shoulder pathology.
The most important variable is how early you seek treatment. Tendons respond well to conservative care when caught early. When tendinitis becomes tendinosis — a degenerative rather than inflammatory process — treatment is more complex.
Suffering from Biceps Tendinitis?
Our team at Pittsburgh Physical Medicine treats this condition with chiropractic care, physical therapy, and soft tissue techniques — under one roof in East Liberty, Pittsburgh.
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