BICEP TENDONITIS? WHEN IN DOUBT CHECK THESE 5 MUSCLES OUT
Knowledge and wisdom aren’t the same thing. This article is about pain at the bicep tendon and why there’s lots of information online but few practical fixes you can use on your own. Here’s the plan for today: start with quick, doable fixes before you think about a longer rehab plan or seeing a doctor, but don’t mistake a quick fix for a half-hearted effort.
Step One: Make sure you’re not dealing with a bicep tendon rupture
See an orthopedic physician right away if:
1) You heard a sudden pop at the shoulder, with swelling and bruising around the bicep. This often happens when you try to lift something that’s too heavy.
2) You notice a Popeye deformity in the bicep. That usually means a tendon tear.
Other reasons for concern:
Weakness and pain when you bend your elbow to flex the biceps or when you rotate your palm upward with the elbow partly bent. This isn’t necessarily a rupture, but a partial tear is possible.
Why this happens:
The bicep tendon can be a source of pain because of where it sits. It’s often pinched between the upper arm bone and nearby structures in the shoulder (usually the acromion and the coracoid process). Impingement happens often, and the shoulder has soft cushions called bursae to handle this compression. When compression becomes frequent or intense, the bicep tendon can become injured, especially in people who do a lot of overhead work or sport.
Does rubbing the bicep tendon prove it’s the problem?
No. Rubbing your finger over the tendon is not a reliable way to diagnose a bicep tendon issue. It’s a common mistake to rely on that test.
What’s the best way to tell if the bicep tendon is injured?
Ultrasound by a physician is the gold standard. Isolating the bicep and testing resistance (for example, a reverse-grip pull-up) can also help. You might have some inflammation near the tendon. Many tendon tests aren’t perfect, so a diagnosis should consider how the injury happened and which movements provoke your pain.
Could front-shoulder pain be coming from something else?
Yes. Muscles in the shoulder and neck can refer pain to the front of the shoulder, just as organs can refer pain to other parts of the body.
Five muscles that commonly refer pain to the front of the shoulder
Note: A lacrosse or tennis ball works well for the drills demonstrated in the video, but a simple tool is fine.
Deltoid
The deltoid’s fibers cross over the bicep tendon. If pressing around the tendon hurts, the deltoid might be irritated rather than the tendon itself.
Biceps
Pain around the bicep tendon is common from overuse or a sudden force on the biceps. If trigger points develop, some soft tissue work and a brief break from heavy lifting can help.
Pectorals/Subclavius
Often the real issue is too much chest work and not enough leg work. Poor resting posture and bad technique can keep the chest muscles tight, leading to impingement and trigger points. The subclavius sits under the pecs and can refer pain to the front of the shoulder; you can usually address this while working the upper fibers of the pecs.
Scalenes
These neck muscles move the neck and can become overactive with forward head posture or head tilt. When you slouch, these muscles may stay activated, increasing tone and trigger points. They also participate in breathing; if you tend to breathe with the chest, these muscles may be stressed. Poor posture and breathing style can raise tension in the neck and chest area. After you do soft tissue work, pay attention to posture and breathing from the diaphragm.
Infraspinatus
This is one of the rotator cuff muscles, located on the shoulder blade. Dysfunction here often shows up as shoulder pain. Trigger points in the infraspinatus can change the timing and strength of the shoulder, especially during overhead activities, sometimes causing an unstable shoulder and more impingement. It’s not easy to treat on your own, but don’t skip it.
Final considerations
Sometimes gentle soft tissue work around the shoulder is enough, but you can’t ignore other factors that may have contributed to the injury. Your goal is to control what you can.
What you can control
1) Normalize the tissues around the shoulder. Treat local trigger points, improve muscle flexibility, and reduce stiffness to restore better shoulder mechanics. This helps the timing and strength of the muscles around the shoulder, supporting stability.
2) Modify your activity for a while. If a specific activity worsens your pain, back off it to give the shoulder a chance to recover. This doesn’t mean weeks of couch time; it means more focus on soft tissue work and mobility, plus a careful, gradual return to exercise. Some mild discomfort during exercise is okay.
Poke the bear, but don’t take it to dinner. (Adriaan Louw)
