A nagging ache at the front of the shoulder that worsens when you lift your arm, reach overhead, or carry weight is one of the most common presentations of biceps tendinitis. It is a condition that affects people across all activity levels and frequently accompanies other shoulder pathology including rotator cuff issues.
What is Biceps Tendinitis?
Biceps tendinitis is inflammation of the long head of the biceps tendon, the tendon that runs from the biceps muscle through the shoulder joint and attaches at the top of the glenoid. When this tendon becomes irritated or inflamed, it produces pain at the front of the shoulder that can radiate down into the upper arm.
It is important to note that biceps tendinitis rarely exists as a completely isolated condition. In a significant proportion of patients, particularly those over 40, it is associated with rotator cuff pathology, subacromial impingement, or biceps pulley lesions, which must be assessed and treated alongside the tendon itself.
Types of Biceps Tendinitis
Causes
Repetitive overhead movements in swimming, tennis, cricket bowling, and weightlifting are common contributing factors. Age-related degeneration of the tendon is the primary mechanism in older patients. A direct injury or sudden overload through the arm can also trigger acute biceps tendinitis.
- Aching pain at the front of the shoulder and upper arm, worsening with lifting, reaching overhead, or carrying objects
- Tenderness when pressing along the bicipital groove at the front of the shoulder
- A deep ache that may be worse after activity and at rest following exercise
- Occasional clicking or snapping in the groove with shoulder movement in more severe cases
Diagnosis
Clinical examination, including palpation of the bicipital groove and provocative testing such as Yergason’s and Speed’s tests, establishes the diagnosis. Ultrasound provides real-time dynamic assessment of the tendon and is particularly useful. MRI is used when associated rotator cuff or labral pathology is suspected.
Treatment
Subpectoral Biceps Tenodesis (surgical)
When biceps tendinitis is persistent, severe, and fails to respond to conservative management, or when it is associated with significant tendon degeneration or instability, Dr. Kushalappa performs a subpectoral biceps tenodesis. The inflamed or damaged tendon is released from its attachment at the top of the shoulder and reattached at a new, lower position on the humerus where it is no longer subject to impingement or instability. The procedure reliably eliminates biceps-related shoulder pain while fully preserving biceps muscle function.
Why Choose Dr. Kushalappa Subbiah in Bangalore?
Dr. Kushalappa Subbiah completed a Fellowship in Shoulder Surgery at the Sydney Shoulder Research Institute, where he trained in advanced arthroscopic shoulder procedures including labral repair and reconstruction. He holds the International Olympic Committee (IOC) Diploma in Sports Medicine, and has direct clinical experience managing shoulder injuries in Indian athletes across cricket, swimming, tennis, and contact sports. He is appointed as a Consultant Shoulder Surgeon at NH Hospital, Bangalore.