Biceps Tendinitis Physical Therapy

This article examines how physical therapy can help alleviate biceps tendinitis. Let's start exploring biceps tendinitis. Biceps tendinitis—also known as bicipital tendinitis—is a common shoulder condition that develops when the biceps tendon becomes irritated or inflamed. The biceps muscle has two tendons at the shoulder joint, and repetitive strain or poor shoulder mechanics can overload these structures, leading to pain and restricted arm movement.

This condition is frequently seen in athletes, manual workers, gym-goers, and individuals who perform repeated overhead activities. Fortunately, physical therapy plays a central role in relieving pain, restoring function, and preventing recurrence without the need for surgery in most cases.

Causes of Biceps Tendinitis

Biceps tendinitis usually develops gradually due to repeated stress on the shoulder. Common contributing factors include:

1. Repetitive Overuse

Activities involving repeated overhead arm movements—such as throwing, swimming, painting, or lifting—place continuous strain on the biceps tendon.

2. Age-Related Tendon Changes

As we age, tendons naturally lose elasticity and strength, making them more vulnerable to inflammation and micro-tears.

3. Rotator Cuff Weakness or Injury

When the rotator cuff muscles are weak or injured, shoulder mechanics are altered, increasing the workload on the biceps tendon.

4. Poor Technique or Posture

Improper lifting form, faulty sports technique, or rounded shoulder posture can significantly increase tendon stress.

5. Existing Shoulder Conditions

Shoulder arthritis, instability, impingement, or a history of injury can raise the risk of developing biceps tendinitis.

Symptoms of Biceps Tendinitis

Individuals with biceps tendinitis often report the following symptoms:

• Front shoulder pain, especially during lifting or overhead movements

• Weakness in the arm, making daily tasks more difficult

• Tenderness over the bicipital groove at the front of the shoulder

• Swelling or warmth around the shoulder region

• Reduced range of motion, particularly when raising or rotating the arm

Symptoms may worsen gradually and become more noticeable with activity.

Activities That Commonly Aggravate the Condition

Certain movements and tasks can intensify symptoms, including:

• Overhead sports such as baseball, tennis, volleyball, and swimming

• Weightlifting, especially presses, curls, and pulling movements, is done with poor form

• Repetitive lifting or carrying tasks at work

• Household activities like painting, drilling, or overhead cleaning

Identifying and modifying these activities is an important part of recovery.

Physical Assessment and Diagnosis

Healthcare professionals use a combination of clinical examination and imaging to diagnose biceps tendinitis:

1. Clinical Examination

The clinician assesses shoulder movement, pain patterns, tenderness, and functional limitations.

2. Imaging Studies

• X-rays rule out bone-related problems

• Ultrasound or MRI helps confirm tendon inflammation, degeneration, or tearing

3. Strength Testing

Evaluates muscle weakness and functional impairment.

4. Special Orthopedic Tests

• Speed’s Test: Pain during resisted shoulder flexion suggests biceps tendon irritation

• Yergason’s Test: Pain during resisted forearm supination and external rotation indicates bicipital involvement

5. Palpation

Direct pressure over the biceps tendon groove often reproduces pain.

Biceps Tendinitis Physical Therapy

Physical therapy is one of the most effective conservative treatments for biceps tendinitis. A structured rehabilitation plan may include:

1. Activity Modification and Rest

Reducing or temporarily avoiding painful movements allows the tendon to calm down and heal.

2. Ice and Heat Therapy

• Ice helps control pain and inflammation in the early stages

• Heat improves circulation and reduces stiffness during recovery

3. Stretching and Strengthening

Targeted exercises improve flexibility, restore muscle balance, and reduce tendon overload.

4. Manual Therapy

Hands-on techniques such as soft tissue mobilization, trigger-point release, and joint mobilization help reduce pain and improve mobility.

5. Postural and Movement Retraining

Correcting posture and faulty movement patterns reduces ongoing stress on the biceps tendon.

6. Therapeutic Modalities

Ultrasound, electrical stimulation (TENS), or laser therapy may be used to reduce pain and promote healing.

Exercises for Biceps Tendinitis

A physiotherapist may prescribe the following exercises based on pain level and recovery stage:

1. Biceps Stretch

Gently extend the arm behind the body with the palm facing down to stretch the biceps tendon.

2. Isometric Biceps Contraction

Press the hand against a wall or resistance without moving the elbow to activate the muscle safely.

3. External Rotation with Resistance Band

Strengthens the rotator cuff, improving shoulder stability and reducing strain on the biceps.

4. Scapular Stabilization Exercises

Rows and shoulder blade squeezes enhance upper-back strength and posture.

5. Controlled Mobility Exercises

Pendulum swings, wall climbs, and assisted arm lifts help restore range of motion without stressing the tendon.

Exercises should always be performed within pain-free limits and progressed gradually.

Frequently Asked Questions

Can physical therapy help biceps tendinitis?

Yes. Physical therapy is one of the most effective treatments. It reduces pain, improves strength, corrects faulty movement patterns, and supports tendon healing. Early intervention leads to faster recovery.

What is the fastest way to heal biceps tendinitis?

The fastest recovery typically includes:

• Rest and activity modification

• Ice application

• Anti-inflammatory medication (if advised by a doctor)

• Structured physical therapy

• Posture and technique correction

• Avoiding repetitive overhead movements

How is biceps tendinitis rehabilitated?

Rehabilitation focuses on:

• Pain control

• Gradual strengthening of the biceps, rotator cuff, and shoulder stabilizers

• Stretching and mobility work

• Manual therapy

• A progressive return to daily and sports activities

Consistency and patience are essential for full recovery.

Read more

1. Shoulder Mobilization Techniques and their Benefits
2. Shoulder and Elbow Pain: Causes and Physiotherapy Exercises
3. Cervical Radiculopathy Physical Therapy Techniques
4. 6 Effective Physiotherapy Exercises for Shoulder Pain Relief
5. How do you fix a weak shoulder?
6. Can Rotator Cuff Tears Heal Without Surgery?

Conclusion

Biceps tendinitis can be painful and limiting, but with proper physical therapy, most individuals recover successfully without the need for surgery. A combination of rest, targeted exercises, posture correction, and gradual return to activity is key to long-term relief.

Addressing the condition early not only shortens recovery time but also reduces the risk of chronic shoulder problems in the future.

About the Author
Dr. Ajay Shakya, MPT, Certified Manual Therapist
Dr. Ajay Shakya is an experienced physiotherapist with over 10 years of expertise in orthopedic and neurological rehabilitation. He specializes in personalized, evidence-based treatment programs designed to restore function and promote long-term wellness.

Disclaimer:
This content is for informational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.