What Is Biceps Tendinopathy?

Jon Grayson

Biceps Tendinopathy, often termed Biceps Tendinitis, is a common overuse or repetitive strain injury. It can occur in the top or bottom part of the bicep muscle. Usually, a person will only have one type of tendonitis rather than experiencing it in both places at once.

Proximal or distal Biceps Tendinopathy?

The biceps muscles (often informally termed ‘the guns’) have 2 heads at the top attaching to the shoulder blade. The long head of the Biceps attaches to the rim just above the ball of the shoulder joint. The short head attaches to the bony bump (Coracoid process) at the front. Hence the name ‘Bi’-ceps.

The lower part of the Biceps has 1 thick tendon attaching to the radius (one of the forearm bones).

The type of Bicep tendonitis a person has depends on which tendon has become affected:

Proximal Bicep tendonitis: This is when there is inflammation at the end of the tendon connecting the biceps muscle to the shoulder.
Distal Bicep tendonitis: This is when inflammation occurs at the end of the tendon connecting the biceps muscle to the elbow.

Tendinopathy or Tendinitis?

As used in many medical terms, ‘itis‘ is latin for inflammation. So Bicep Tendinitis basically means inflammation of the tendon. ‘Opathy’ is latin for ‘disorder of’, which better describes the overall injury as over time it will go through different stages. Hence the term Bicep Tendinopathy. Due to a poor blood supply and repetitive strain nature, tendons take time to heal. Usually months.

What’s going on?

Tendons (and in general all soft tissue) are in a constant continuum of healing. When a tendon becomes painful in the first 3-6 weeks, be it a first time episode or a flare up of a persistent problem, we class this as the ‘reactive phase’. Typically when symptoms are more acute and irritable. For example when lifting the weight of your own arm or stretching out.

Over time the inflammation becomes more degenerative in nature due to a build up of scar tissue. This is termed as a ‘disrepair’ of the natural healing process. Bicep Tendinopathy symptoms in this phase include pain that is worse when lifting weights or repeating overhead activities. This can usually improve as you get more mobile but increase again when trying too much.

Have patience

Commonly tendon irritations can occur in 2 main points, in the mid-tendon or at its insertion into the bone. Insertional Tendinopathies can be more irritable and therefore take longer to heal.

Diagnosis

1 simple way to establish what stage of healing the Biceps tendon is in, and provide diagnosis confirmation is using Ultrasound Scans. Take a look here for more information on our specialist service for Ultrasound Diagnosis.