What Are Biceps Tendon Injuries and How Do You Treat Them?

Feeling an unusually sharp pain in your upper arm and shoulder after lifting something heavy can be very concerning. You might have injured a biceps tendon. These injuries are fairly common, especially among people who play sports or spend a lot of time lifting weights. A biceps tendon injury can be painful and limit how well your arm works. But with the right treatment and care, recovery is likely.

What Is a Biceps Tendon?

Your biceps muscle is located on the front of your upper arm. It helps you bend your elbow and turn your palm up. Tendons connect this muscle to your bones. At the top of your arm, the biceps has two tendons that attach it to the shoulder. At the bottom, there’s one tendon that attaches it near the elbow.

When one of these tendons gets damaged, it’s called a biceps tendon injury. This might mean the tendon is irritated, strained, partly torn, or completely torn away from the bone.

Common Types of Injury

Biceps tendon injuries usually fall into one of three categories:

• Tendonitis: The tendon becomes inflamed, usually from overuse. This often starts gradually and causes a dull ache.

• Partial tear: The tendon is damaged but still partly attached.

• Complete tear: A biceps tendon tear is when the tendon is fully torn away from the bone. This can cause a noticeable change in the shape of your arm.

Most full tears happen at the shoulder. The tendon near the elbow can also tear, but this is less common.

What Causes a Biceps Tendon Injury?

Biceps tendon injuries often develop over time. Repeating the same motion, especially overhead movements, can wear down the tendon. Sports like swimming, baseball, or tennis, and jobs that require a lot of lifting, can increase the chances of injury.

A sudden strain can also cause a tear. Lifting a heavy object the wrong way or falling on your arm can damage the tendon quickly. These injuries are more common in people over 40, since tendons naturally weaken with age.

There are other risk factors, too. Smoking, steroid use, and some medications can affect tendon strength. Shoulder problems, like rotator cuff injuries, may also increase the chances of tearing a biceps tendon.

Symptoms to Watch For

Some injuries happen slowly, while others are sudden. A person might feel:

• Sharp pain in the upper arm or elbow

• A popping sound or sensation at the time of injury

• Swelling and bruising

• Weakness when bending the elbow or turning the hand

• A bump in the upper arm where the muscle bunches up

If the tendon is only inflamed, the pain may start as soreness that gets worse during activity. In the case of a complete tear, strength often drops right away.

How Injuries Are Diagnosed

A healthcare provider will start by asking how the pain started and what movements make it worse. They’ll check for tenderness, swelling, and changes in how the arm looks. There are simple tests that can help figure out which tendon might be involved.

If a tear is suspected, imaging tests can help. An X-ray can show if there are changes in the bones or signs of arthritis. An MRI or ultrasound can show the soft tissues, including whether the tendon is torn or just irritated.

Treatment Options

The treatment plan depends on the type of injury, the person’s activity level, and how much the injury affects daily life.

Non-Surgical Treatment

For tendonitis or partial tears, rest and physical therapy are often enough. Ice, anti-inflammatory medicine, and stretching can help reduce pain. Strengthening exercises guided by a physical therapist can rebuild stability in the arm and shoulder.

Some people get cortisone shots to ease the pain. These can help with short-term relief, but they are used carefully, since they can weaken the tendon if given too often.

In some cases, especially with shoulder tendon tears, people can continue with normal activities without surgery. The muscle may still work well because the other tendon remains attached.

Surgery

Surgery may be a better option if the tendon is fully torn and the person wants to restore full strength. This is more common for people who work with their arms or athletes who need high performance.

In distal biceps tears near the elbow, surgery is often recommended. Without repair, people can lose up to half their arm strength for turning and lifting.

Surgeons may reattach the tendon with anchors or small buttons. For shoulder tears, two common procedures are:

• Tenodesis: The damaged part of the tendon is removed, and the rest is attached to a different spot on the upper arm bone.

• Tenotomy: The tendon is released without being reattached. This usually works well for older patients who don’t mind a possible change in arm shape (sometimes called "Popeye deformity").

Recovery and Rehab

If surgery is needed, recovery takes time. Most people wear a sling or brace for a few weeks. After that, physical therapy starts to restore motion and rebuild strength. Full recovery can take several months.

For people who don’t have surgery, physical therapy and rehabilitative exercises can play a big role in recovery. Stretching and strengthening exercises can improve how the tendon functions and help avoid future injury. In both cases, staying active in the right ways helps with healing.

Who’s Most at Risk?

Biceps injuries happen most often in men over 40. People who lift weights, throw, or do overhead work are at higher risk. It’s also more likely in those who have had shoulder injuries in the past or who have health conditions that affect the joints or soft tissues.

How to Lower the Risk of Injury

You can’t stop every injury, but some habits make a big difference:

• Use proper lifting techniques

• Warm up and stretch before exercise

• Don’t ignore shoulder pain

• Strengthen the muscles that support the shoulder

• Avoid repetitive overhead movements when possible

• Stay active as you age

If something feels off during a workout or while lifting, it’s a good idea to stop and check in with your body. Pain that lasts more than a few days or keeps coming back may be a sign that something needs to be looked at more closely.

Need Help? Contact a Specialist

Biceps tendon injuries can happen slowly or all at once, but they usually come with warning signs. Knowing how to spot those signs early and getting the right care can make a big difference in recovery. Whether your injury needs rest or surgery, most people are able to return to their usual activities with the right plan.

If you're dealing with arm pain, weakness, or a change in the shape of your muscle, don’t wait too long to get it looked at. A small issue can turn into a bigger one if left alone. We're here to help. Contact the specialists at The Centers for Advanced Orthopaedics. Or, if you're looking for some advice over the phone, try VantaStat.com.