Is this the same as a torn biceps?

No. Biceps tendonitis at the shoulder is irritation of the long head of the biceps tendon, not a rupture. A distal biceps rupture is a separate injury at the elbow. Tendonitis causes front-of-shoulder pain and usually improves without surgery.

Why does my whole shoulder need to be checked?

Biceps tendonitis rarely occurs by itself. It usually accompanies a rotator cuff problem, impingement, or a labral (SLAP) injury, so an ultrasound or MRI evaluates those structures too. Treating only the tendon while missing the larger problem tends to disappoint, which is why the whole shoulder is assessed.

What is a biceps tenodesis?

It is a procedure that reattaches the long head of the biceps tendon to the bone just outside the shoulder joint. For pain that persists despite rehabilitation, or when the tendon is significantly worn, it reliably relieves the pain and is often combined with treatment of an associated rotator cuff or labral problem.

Biceps Tendonitis (Shoulder), Steven J. Lee, MD

The long head of the biceps tendon runs through the front of the shoulder and into the joint. When it becomes irritated or worn, it causes pain at the front of the shoulder that can radiate down the upper arm, worse with lifting and overhead activity.

Biceps tendonitis rarely occurs in isolation. It usually accompanies rotator cuff disease, impingement, or a labral (SLAP) problem, so the evaluation looks at the whole shoulder rather than the tendon alone.

Symptoms

Common complaints include:

Aching pain at the front of the shoulder
Pain radiating down the front of the upper arm
Pain with lifting, pulling, or overhead activity
Tenderness over the tendon at the front of the shoulder

How it is diagnosed

The exam localizes tenderness to the biceps tendon and uses specific tests that load it. Because biceps tendonitis usually travels with other shoulder problems, an ultrasound or MRI evaluates the cuff and labrum as well, which shapes the treatment.

Dr. Lee's approach

Most biceps tendonitis improves without surgery. Dr. Lee's treatment starts with activity modification, a rotator-cuff and shoulder-blade rehabilitation program, anti-inflammatory measures, and, when needed, a targeted injection such as PRP or corticosteroid depending on what part of the spectrum the tendon is in.

When pain persists, or when the tendon is significantly worn or part of a larger problem, a biceps tenodesis reattaches the tendon outside the joint, which reliably relieves the pain. It is frequently done at the same time as treatment for an associated rotator cuff or labral problem.

Non-surgical treatment

Most patients improve with:

Activity modification to reduce provocative lifting and overhead loading
A rotator-cuff and shoulder-blade physical therapy program
Anti-inflammatory measures
A targeted corticosteroid injection in selected cases

Surgical treatment

When pain persists or the tendon is significantly worn, a biceps tenodesis reattaches the tendon to the bone outside the joint, which reliably relieves the pain. It is often combined with treatment of a coexisting rotator cuff tear or labral injury.

Recovery timeline

Recovery depends on whether surgery is needed:

Non-surgical
Activity modification and a therapy program over several weeks, with gradual improvement.
After tenodesis, weeks 0 to 4
Sling to protect the repair for 4-6 weeks, with gentle guided motion.
After tenodesis, weeks 4 to 12
Progressive strengthening and a graded return to lifting and overhead activity.

What patients commonly misunderstand

Two things to understand:

It rarely travels alone. Biceps tendonitis usually accompanies a rotator cuff or labral problem, so treating only the tendon may miss the larger issue. The evaluation looks at the whole shoulder.
Tenodesis is reliable. When surgery is needed, reattaching the biceps tendon outside the joint reliably relieves the pain and is often done alongside other shoulder treatment.

This page is general educational content authored by Dr. Lee. It is not a substitute for individual medical advice. Every patient's case is different, book a consultation to discuss yours.

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Aching pain at the front of the shoulder? Usually treatable without surgery.

Biceps tendonitis improves without surgery in most cases, with rehabilitation and activity modification. Because it usually accompanies other shoulder problems, the evaluation looks at the whole shoulder, and a biceps tenodesis reliably relieves the pain when surgery is needed.

Biceps Tendonitis: pain at the front of the shoulder.