Proximal Biceps Tendonitis

What Is Tendonitis?

Tendonitis is when a tendon becomes inflamed, irritated, and swollen. Tendons are tough bands of soft tissue that connect muscle to bone. They are pulled when muscles contract to allow body parts to move.

What Is Proximal Biceps Tendonitis?

The biceps is the muscle on the front of the upper arm. The upper part of the biceps is called the proximal biceps. Proximal biceps tendonitis is tendonitis of the tendon that connects the upper part of the biceps to the shoulder.

Biceps tendonitis can happen on its own, or with or after a shoulder injury.

What Are the Signs & Symptoms of Proximal Biceps Tendonitis?

People with proximal biceps tendonitis usually have pain in the front of the shoulder. Most of the time, the pain starts slowly and gets worse the more a person uses that arm. The pain may be worse at night or with lifting, pulling, or reaching overhead. The shoulder may get stiff or weak.

What Causes Proximal Biceps Tendonitis?

Proximal biceps tendonitis usually is an overuse injury. This means it happens from doing the same movement over and over again.

Proximal biceps tendonitis usually affects adults and older teens whose growth plates have closed (which means they've stopped growing). Teens who play sports with a lot of arm movement, especially overhead movements — such as in baseball, swimming, volleyball, and tennis — are more likely to get it.

How Is Proximal Biceps Tendonitis Diagnosed?

To diagnose proximal biceps tendonitis, health care providers:

• ask about symptoms
• do an exam, paying special attention to the upper arm and shoulder

Occasionally, doctors order imaging tests such as an X-ray or MRI to check for or rule out other problems.

How Is Proximal Biceps Tendonitis Treated?

Someone with proximal biceps tendonitis needs to rest the arm and shoulder.

This includes:

• Gentle stretching of the arm overhead, to the side, and behind the body. "Spider walking" fingertips up the wall to the front and side can assist with a gentle stretch. Slow, controlled arm circles also can stretch the biceps and shoulder.
• Changes to some activities, such as throwing underhand and doing an underhand serve in tennis, which can make it more comfortable to play.
• Shoulder rehabilitation and looking closely at techniques for pitching, spiking, serving, swimming strokes, etc.

Your health care provider also may recommend some or all of these:

• Putting ice or a cold pack on the shoulder a few times a day for 15 minutes at a time. (Put a towel over the skin to protect it from the cold.)
• Taking medicine for pain and swelling, such as ibuprofen (Advil, Motrin, or store brand) OR naproxen (Aleve or store brand) for 5–7 days. Follow the directions that come with the medicine for how much to take and how often.
• Physical therapy (PT) or a home exercise program for stretching and strengthening.

If these treatments don't help, doctors may consider steroid injections in the area of the biceps tendon and shoulder.

When Can I Go Back to Sports?

Teen with biceps tendonitis can return to sports when the pain is better and they:

• have regained their full range of motion
• don't have any numbness or tingling
• are back to their full strength

Going back to sports too soon puts someone at risk for another injury that could possibly be more serious. Your health care provider will let you know when it's safe for you to go back to sports.

What Else Should I Know?

Proximal biceps tendonitis usually heals well in 6 weeks to a few months and doesn't cause any long-term problems. It's important to rest, stretch, and rehabilitate the arm and shoulder long enough to let it heal fully. A slow return to activities and sports can help prevent the tendonitis from coming back.