1. Introduction

Bicep tendonitis is swelling or inflammation in the tendons that connect the biceps to the shoulders. A tendon is a tissue strip that allows the movements of our limbs thanks to the connection between our muscles and bones.

Bicep tendonitis is a common condition among athletes that mostly arises due to the overuse of muscled. It can be relieved with simple rest and medication. However, you may need surgery to repair the tendon if its condition is severe.

This article will help you learn everything about bicep tendonitis, including its causes, symptoms, methods of treatment, and prevention.

2. Anatomy

The bicep is the muscle located on the upper part of your forearm. It consists of two tendons (long and short heads) which connect the biceps to the shoulders.

• The short head attaches to the coracoid process on the shoulder blade. The long head attaches to the glenoid, i.e. the top of the shoulder socket.

In addition, there is a third tendon at the distal end which connects the bicep to the radius bone at the elbow.

• Despite being tough, tendons can become pained and sore if overused. This can lead to tendonitis either in the shoulders or biceps.

3. Bicep Tendonitis Description

Bicep Tendonitis (also known as bicep tendonitis) refers to swelling of the long head in the bicep muscle. In this condition, micro-tears are produced in the tendons due to excessive use of your biceps.

3.1. Bicep tendonitis swelling

During the early stages of tendonitis, the tendon becomes swollen and inflamed. As tendonitis develops, the tendon sheath grows and thickens. Sometimes, the tendon can grow larger over time.

In the later stage, the tendon often becomes dark red in color due to inflammation. Sometimes, the damage can also lead to a partial or complete tendon tear.

3.2. Types of Bicep Tendonitis

Depending upon the type of tendon affected, there are two types of bicep tendonitis:

Proximal Bicep Tendonitis:

It refers to the inflammation that occurs at the end of the tendon that connects the bicep muscle to the shoulders.

Distal Bicep Tendonitis:

It refers to the inflammation that occurs at the end of the tendon that connects the muscle to the elbow.

Rotator Cuff Tendonitis:

The rotator cuff is a muscle group surrounding and supporting the shoulder joint. The tendons and muscles work together to keep the upper arm bone firmly in place in the shoulder socket.

Rotator Cuff Tendonitis is a condition in which the rotator cuff is irritated or inflamed. This disorder is more common in elite athletes and people who participate in various activities on a regular basis.

4. Symptoms

Most patients experience deep pain in the anterior part of the shoulder. The common symptoms include:

A sensation of clicking or snapping while moving your shoulders

You may hear a click or snap while moving your arm up and down. This is because bicep tendonitis can make it difficult to move the arm properly.

Aching pain in the shoulders and arms:

Shoulder pain is a classic symptom of bicep tendonitis. It usually starts at the shoulder front and then travels down the arm. Such pain can often develop gradually without an apparent trigger.
You may also experience pain after a sudden event, e.g. abrupt lifting, etc.

Other symptoms include:

• Swelling and changing skin color in the affected area
• Difficulty moving the joints
• Muscle weakness and pain that enhances with movements

5. Causes and Risk Factors

Causes:

Repetitive Motions

Activities like sports require repetitive motion of the bicep muscles, i.e. the main cause of tendonitis. For instance, athletes involved in swimming, tennis, baseball, etc., have a high risk of tendon damage in their arms, elbows, and shoulders due to frequent body movements.

Sudden Load

The sudden lifting of heavy objects is another factor that may make people more prone to biceps tendonitis. This includes all the activities that can cause sudden damage to tendons such as lowering the body during a pull-up, lifting or catching a heavy object, clearing heavy snow, etc.

Everyday Wear and Tear

Most of the time, a lifetime of normal activities can damage the bicep tendon. Everyday wear and tear may slowly weaken our tendons as we age. Such degeneration gets worse over time, leading to bicep tendonitis.

Already Existing Injury

The bicep tendon can become inflamed as a result of pre-existing injuries to the shoulders like shoulder impingement, etc. Because the bicep tendon is easy to dislocate from its natural position, abnormalities in the bones of the shoulder might increase the risk of injury.

Poor Posture

Poor body posture over a long period of time can also damage the muscle tendons, resulting in tendonitis.

Risk Factors:

Smoking:

Poor tendon quality and strength are linked to nicotine use according to the American Academy of Orthopaedic Surgeons (AAOS). Hence, people who smoke are at higher risk of bicep tendonitis compared to people who don’t.

Age:

Older people are more prone to biceps tendonitis because the muscles have a natural tendency to weaken with age.

Overhead Heavy Lifting:

People who are frequently lifting heavy objects, e.g. weight lifters, and laborers have a higher risk of getting biceps tendonitis.

6. Diagnosis

Biceps tendonitis can be diagnosed either physically or with the help of imaging tests.

6.1. Physical Diagnosis

In such a diagnosis, your doctor will examine your arm movements after discussing your symptoms and medical history. To confirm the diagnosis, the doctor may look for shoulder instability, range of motion, and muscle strength.

6.2. Tests

Various imaging tests are used to ensure tendon damage after physical diagnosis. These include:

• MRI (Magnetic Resonance Imaging): MRI scans can show soft tissues that help identify tendon tears.
• X-Ray: This scan cannot show soft tissues but they can visualize bones that help to determine possible causes of injury.

7. How to Treat Bicep Tendonitis?

Depending upon the severity, you can either treat bicep tendonitis non-surgically at home or surgically in the hospital.

7.1. Non-Surgical (at home) Treatment

Bicep tendonitis can be completely resolved by non-surgical treatment in the early stages. As soon as you experience any symptoms, get yourself examined by an orthopedic doctor. You can treat mild bicep tendonitis non-surgically using the following simple methods at home.

Ice:

Try applying ice packs to the affected area for at least 20 minutes. It helps to reduce swelling and relieve pain.

Rest:

Avoid any strenuous activity and give your tendons ample time to heal.

Medication:

Take prescribed medication to relieve the pain at home. Your doctor may recommend some over-the-counter drugs, e.g. nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen, etc. These drugs help reduce inflammation and alleviate pain effectively.

Steroid Injections:

Injecting steroids is another way to reduce pain. However, be very cautious while taking steroids as these can further weaken the tendon in some cases.

Physical Therapy:

Last but not least, physical therapy is the final non-surgical treatment that can restore strength and range of motion in your shoulders. Try performing specific stretching and strengthening exercises recommended by your physician.

7.2. Surgical Treatment

Bicep tendonitis usually responds well to non-surgical treatments. However, if the condition worsens, there are many surgical options available to cure biceps tendonitis effectively.

Common surgery options include repairing or removing the damaged tendon to restore normal function.

The type of surgical procedure used depends on the level of injury and the type of tendon affected.

Most of these surgeries are performed arthroscopically, where a small camera called an arthroscope is inserted into your shoulder joint. This camera then displays the internal images on the screen that helps your doctor to perform the surgery.

7.3. Kinesio Taping for Biceps Tendonitis

Kinesio tape is a type of therapeutic tape that is used to treat and prevent bicep tendonitis. Here’s how you can apply this tape to treat your tendonitis pain.

• Take a two-inch wide K-tape with a slit down the middle. Anchor one end of the tape just above the elbow without any tension.
• Then spread the tape around the biceps tendons and anchor the other end at the shoulder without tension.
• Apply the second tape from one end of the shoulder to another to reduce inflammation and allow stabilization.

8. How to Sleep with Biceps Tendonitis?

When you have bicep tendonitis, getting a decent night's sleep is difficult. Finding a comfortable sleeping position that doesn't place additional strain on your shoulder joint might be difficult.

It is better to sleep on your back. If you sleep on your side, choose the side that isn't so unpleasant. Adding more cushions around your body will help you sleep in a more comfortable position. If you sleep on your stomach, place a thin pillow beneath your hips to maintain your spine straight. For further support, place rolled-up hand towels beneath your shoulders.

9. Recovery Period

Mild bicep tendonitis lasts only one to two weeks. But in the case of surgeries, the recovery time can be prolonged based on the level of severity.

10. Prevention

Because overuse is the leading cause of tendonitis, the best remedy is prevention. It's critical to prevent or change the behavior that is causing the problem.

When conducting physical activities, start cautiously and gradually increase your level of activity. Restrict the number of rounds and the amount of force you normally use. Stop if you experience any unexpected pain. Avoid underlying issues like bad posture or technique in sports or at work.