Biceps Tendon Injury

What is a biceps tendon injury?

A strain is a stretch or tear of a muscle or tendon. Tendons are strong bands of connective tissue that attach muscle to bone. When a tendon is acutely injured it is called a strain. Tendonitis is when a tendon is inflamed. When there are micro-tears in a tendon from repeated injury it is called tendinosis. Tendinopathy is the term for both inflammation and micro-tears.

The biceps muscle is in the front part of the upper arm. The biceps tendons attach the muscle to the elbow and in 2 places at the shoulder. When the biceps tendons are inflamed it usually causes pain in the front part of the shoulder or upper arm.

How does it occur?

Biceps tendinopathy occurs from overuse of the arm and shoulder or from an injury to the biceps tendon. A biceps strain can occur when the arm is pulled in a sudden awkward motion or from overuse.

What are the symptoms?

You feel pain when you move your arm and shoulder, especially when you move your arm forward over shoulder height. You feel pain when you touch the front of your shoulder or with actions such as throwing.

How is it diagnosed?

Your healthcare provider will examine your arm and shoulder for tenderness along the biceps muscle and biceps tendons. He or she will check for pain with movement and check the strength of your biceps.

How is it treated?

To treat this condition:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time.
• You could also do ice massage. To do this, first freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over the area for 5 to 10 minutes. Do this several times a day while you have pain.
• Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• Your provider may give you an injection of a corticosteroid medicine.
• Follow your provider’s instructions for doing exercises to help you recover.
• After you recover from your acute injury, use moist heat for 10 to 15 minutes at a time before you do warm-up and stretching exercises. Do not use heat if you have swelling.

How long will the effects last?

The length of recovery depends on your age, health, and if you have had a previous injury. Recovery time also depends on the severity of the injury. A mild injury may recover within a few weeks, but a severe injury may take 6 weeks or longer to recover. You need to stop doing the activities that cause pain until the tendon has healed. If you continue doing activities that cause the tendon pain, your symptoms will return and it will take longer to recover.

Some serious strains of the biceps may involve tearing of the attachment of the tendon inside the shoulder joint. These injuries usually have persistent pain and weakness. Be sure to follow-up with your provider if your injury does not get better. Surgery may be needed.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your tendon recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal is to return to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your normal activities when:

• Your injured shoulder has full range of motion without pain.
• Your injured shoulder is as strong as the uninjured shoulder.

How can I prevent a biceps injury?

The best way to prevent a biceps injury is to warm-up properly and stretch your arm and shoulder before your activity.