Key Points about Bicep Tendon Injuries

  • Bicep tendon injuries are common in athletes, including swimmers, pitchers, and tennis players, who participate in sports that require repetitive elbow, shoulder, and bicep motions.
  • Bicep tendon injuries can be acute, meaning the injury occurred suddenly, or chronic, meaning that damage occurred over time.
  • Symptoms of bicep tendon injuries can include pain at the injury site or throughout the arm, swelling, bruising, warmth to the touch, and a popping sound at the time of injury. Bicep tendon injuries also can include difficulty turning the arm and increased fatigue of the arm during activity.
  • Many people with bicep tendon injuries can find relief of symptoms with rest, physical therapy, nonsteroidal anti-inflammatory drugs to relieve inflammation, and other self-care measures. Some people with bicep tendon injuries may require surgery, especially if a large portion of or the entire tendon is torn.

Overview

The bicep muscle is located in the upper part of the front of the arm between the elbow and the shoulder. Tendons are stretchy bands that connect muscles to bones. Bicep tendons attach the bicep muscle to the elbow and shoulder bones. A bicep tendon injury is a tear to the bicep tendon.

People use their bicep tendons and muscles when they turn or bend their arms. There are three types of bicep tendon injuries:

  • A bicep tendon injury at the shoulder occurs when one of the tendons connecting the bicep to the shoulder tears. This is called a proximal bicep tendon tear.
  • A bicep tendon injury at the elbow occurs when one of the tendons connecting the bicep to the elbow tears. This is called a distal bicep tear.
  • Inflammation or irritation in the bicep tendon is a type of bicep tendon injury that is caused by many small tears to the bicep tendon. This is called tendonitis.

Common causes of bicep tendon injuries include:

  • Overuse from exercises or activities that involve lifting the arm over the head, such as swimming, tennis, or pitching.
  • Trauma to the tendon, such as falling on the arm or lifting something heavy.

Bicep tendon injuries can take months to heal. Most people with bicep tendon injuries who receive appropriate treatment will begin to see improvement in two to three months. For more severe cases, treatment may include surgery and longer recovery time.

Bicep tendon injury causes

Many bicep tendon injuries are caused by overuse and repetitive motion during athletic or work-related activities, including swimming, pitching, playing tennis, or lifting heavy items.

Other causes include:

  • Sudden trauma
  • Normal aging/wear and tear

Bicep tendon injury symptoms

Symptoms of bicep tendon injuries can develop suddenly or over a period of time.

Signs or symptoms include:

  • Pain at the injury site or throughout the arm
  • Swelling
  • Bruising
  • Weakness in the arm
  • Warmth in the affected area
  • A snapping or popping noise at the time of injury
  • Difficulty turning or twisting the arm
  • Increased fatigue during activity

Bicep tendon injury complications

If left untreated, complications of bicep tendon injuries can develop.

Possible complications include:

  • Worsened pain
  • Increased instability of foot and ankle
  • Tendon rupture
  • Subluxation, or movement of tendons from their normal position

Bicep tendon injury risk factors

There are a few factors that can increase your chances of developing bicep tendon injury, including:

  • Bicep tendon injuries are common in people who participate in activities that require repetitive elbow, shoulder, and bicep motions.
  • As people age, their tendons stretch and get thinner, making them more susceptible to a bicep tendon injury.
  • According to the American Academy of Orthopaedic Surgeons, men over age 30 are more susceptible to bicep tendon injuries.
  • Smoking products with nicotine can weaken tendons.

Bicep tendon injury prevention

Some bicep tendon injuries cannot be prevented. For example, bicep tendon injuries that occur as a result of trauma may not be prevented. In other cases, you can prevent bicep tendon injuries by taking a few precautions. Some lifestyle modifications you can make to prevent bicep tendon injuries include:

  • Stretch and warm-up before exercise or prolonged periods of movement.
  • When starting a new exercise routine, increase the intensity gradually.
  • Use the appropriate form and technique when exercising or lifting heavy objects.

Bicep tendon injury diagnosis

Your doctor can diagnose bicep tendon injuries. During a clinic visit, your doctor will perform a physical exam and take a full medical history. Your doctor also will test the strength and range of motion in your bicep, elbow, and shoulder. In some cases, your doctor will order imaging tests such as:

  • X-ray.
  • MRI.

These tests may be able to determine what is causing your pain.

Bicep tendon injury treatment

As with most injuries, recovery from a bicep tendon injury depends on how severe the bicep tendon injury is. Most bicep tendon injuries can be treated with nonsurgical treatments. Many people experience symptom relief within two to three months with rest, physical therapy, and medication.

If your pain is affecting your ability to perform your daily activities, your doctor may recommend a nonsurgical treatment such as:

  • Staying off the affected foot and pausing strenuous exercise is imperative during rehabilitation.
  • Putting a cold pack on the bicep tendon injury several times a day for 20 minutes at a time can help relieve pain and make movement easier.
  • Physical therapy. Physical therapy is vital, first to reduce pain and swelling and then to increase strength and improve range of motion.
  • OTC medications. Over-the-counter pain relievers such as ibuprofen or naproxen can relieve pain caused by bicep tendon injuries.

In some cases, bicep tendon injuries require surgical treatment. The goal of surgery is to reattach the bicep tendon to the bone. Rehabilitation after surgery often includes physical therapy.

When to Seek Care

If your pain lasts more than a week, is severe, or is progressively worsening, call your doctor to schedule an appointment.

Next Steps

Your doctor will develop a treatment plan customized to your case. Carefully follow your doctor’s treatment instructions.

If your pain intensifies, call your doctor right away to discuss the next steps. You may need a more advanced treatment option if a first-line conservative treatment is not effective.