Biceps Tendonitis

Biceps tendonitis, also called bicipital tendonitis, is inflammation in the main tendon that attaches the top of the biceps muscle to the shoulder. The most common cause is overuse from certain types of work or sports activities. Biceps tendonitis may develop gradually from the effects of wear and tear, or it can happen suddenly from a direct injury. The biceps tendon may also become inflamed in response to other problems in the shoulder.

Patients with biceps tendonitis report a deep ache directly in the front and top of the shoulder. The ache may spread down to the main part of the biceps muscle. This pain is usually made worse with overhead activities. Resting the shoulder generally eases pain.

Biceps Tendons and Shoulder Anatomy

The biceps muscle goes from the shoulder to the elbow on the front of the upper arm. Two separate tendons connect the upper part of the biceps muscle to the shoulder. The upper two tendons of the biceps are called the proximal biceps tendons, because they are closer to the top of the arm.

The main proximal tendon is the long head of the biceps. It connects the biceps muscle to the top of the shoulder socket (the glenoid). It also blends with the cartilage rim around the glenoid (the labrum). The labrum is a rim of soft tissue that turns the flat surface of the glenoid into a deeper socket. This arrangement improves the fit of the ball (humeral head) that fits in the socket.

Beginning at the top of the glenoid, the tendon of the long head of the biceps runs in front of the humeral head. The tendon passes within the bicipital groove of the humerus and is held in place by the transverse humeral ligament. This arrangement keeps the humeral head from sliding too far up or forward within the glenoid.

Causes of Biceps Tendonitis

Continuous or repetitive shoulder actions can cause overuse of the biceps tendon. Damaged cells within the tendon don't have time to recuperate. The cells are unable to repair themselves, leading to tendonitis. This is common in sports or work activities that require frequent and repeated use of the arm, especially when the arm motions are performed overhead. Athletes who throw, swim, or swing a racquet are at greatest risk of developing biceps tendonitis.