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Physical Therapy Guide for Biceps Tendonitis

Physical Therapy Guide for Biceps Tendonitis

If you've started experiencing pain in your shoulder or upper arm, there's a chance you have biceps tendonitis, which occurs due to biceps tendon inflammation and irritation.

As with any physical discomfort, this too can impact your life negatively, from being merely irritating to limiting the shoulder function and hindering the performing your usual tasks and movements.

One of the most common and effective treatments is biceps tendonitis physical therapy which can improve mobility, reduce pain, and allow you to go back to normal life.

What is Biceps Tendinitis?

The biceps tendon is a part of the biceps muscle. It stabilizes the front of the shoulder and is made of two parts: the long and short head.

The short head connects the tendon to the front of the shoulder blade.

What is Biceps Tendinitis?

The long head runs the entire arm's length and attaches to the shoulder blade. The long head is most commonly affected by inflammation and swelling that cause pain and discomfort.

Biceps tendinitis occurs when an irregularly strong tension, compression, or shearing is applied to the tendon and irritates it. The tendon can also thicken with age because of micro-trauma that causes rubbing on the tendon.

Biceps tendinitis causes include:

  • Repetitive movement and activities that involve overhead movement of your arms, e.g., lifting boxes or playing tennis.

  • Weak rotator cuff muscles in the upper back and rotator cuff tears

  • Shoulder joint hypermobility and muscle tightness.

  • A sudden increase in exercise intensity

  • Aging and incorrect body mechanics (the way someone moves their body)

  • Poor posture and general wear and tear

  • Injury, shoulder impingement

Biceps tendonitis physical therapy is one of the best options for treatment and recovery.

What Are the Symptoms of Biceps Tendinitis?

Many people ignore the symptoms of biceps tendinitis, such as bicep tendonitis and shoulder pain, worsening the condition.

While the symptoms may vary, it is essential to visit your doctor or another health provider, such as a physical therapist, if you experience any of them to get diagnosed and start treatment.

What Are the Symptoms of Biceps Tendinitis?

Credits: OrthoInfo

Biceps tendinitis symptoms include:

  • Pain in the upper arm and shoulder that worsens with movement

  • Weakness in the arm, difficulty lifting it, and overall restricted mobility

  • Swelling in the area that may intensify in high temperatures

  • Change in skin color, tenderness to touch

  • Snapping, clicking, and grating when moving the shoulder

  • Pain that radiates from shoulder to neck or front of the arm

How is Biceps Tendinitis Diagnosed?

Bicep tendonitis physical therapy starts with a diagnosis.

Your doctor or physical therapist will first ask you to describe your symptoms, review your medical history, and then move on to a physical exam.

This comprehensive shoulder and upper trunk exam are necessary to assess your motion, strength, and flexibility.

How is Biceps Tendinitis Diagnosed?

During the exam, besides asking the patient to perform the activities, the therapist will also touch the affected areas of the shoulder and the nearby areas to determine what causes the pain.

While an X-ray or MRI test is rarely needed, your therapist may order them to confirm the diagnosis or rule out (or also confirm) certain other conditions.

Such a long process is needed because this condition is challenging to diagnose, as there are many other conditions, such as arthritis or rotator cuff tear, that cause similar symptoms. It is vital to have a conclusive diagnosis before starting the treatment for bicep tendonitis.

Physical Therapy Treatment for Biceps Tendinitis

The most common and effective treatment for bicep tendonitis is physical therapy.

It offers many modalities to reduce pain and inflammation, improve the range of motion, and heal.


Physical therapy exercises for biceps tendonitis are an integral part of treatment.

It's vital to remember that these exercises should never be painful and to stop performing them if they are.

Your physical therapist will create a custom program and routine, but commonly, the exercises include the following:

Rotator cuff muscle exercises. These exercises strengthen rotator cuff muscles helping reduce inflammation and decrease pain, and will most likely include internal and external rotation movements.

Range of motion exercises. These exercises help improve shoulder mobility and function and can be done with PT's assistance or on your own.

Endurance exercises. In your program, you'll likely need to work on your endurance which promotes blood flow to the affected areas and helps improve movement and function.

While you will initially perform these exercises with your therapist, you'll also get an at-home program to maintain regular movement and heal faster.

Physical Therapy Treatment for Biceps Tendinitis

Heat and ice

Both heat and ice can be used during physical therapy to reduce pain and promote healing.

Your PT will use hot towels on the affected area. Heat increases blood flow and delivers an oxygen and nutrient boost. It can help reduce inflammation, improve mobility, and flush out waste material build-up.

Ice is often used to reduce swelling and inflammation and manage localized pain. Ice is placed on the affected area, but keep in mind that it should not hurt the skin and if you feel discomfort, let your therapist know.

Electrical Stimulation

Electrical or e-stim is used to decrease pain, improve muscle function, or increase circulation by placing small electrodes around the shoulder and upper arm with electrical impulses.


Bicep tendonitis massage is one of the most commonly used modalities for biceps tendinitis treatment. It helps stimulate collagen formation around the tendon, decrease pain, and improve circulation and tissue mobility.

Dry Needling

It's a newer form of treatment where the therapist injects tiny needles into a tendon which helps decrease pain and muscle spasms and improve blood flow.

How Can Physical Therapy Help

Physical therapy for bicep tendonitis has been shown to treat the condition effectively.

After a thorough examination and diagnosis, your physical therapist will develop a custom plan to achieve your treatment goals.

Many patients ask us how long does bicep tendonitis take to heal. It's not an easy question to answer as it all depends on the individual condition and may take from 6 weeks to a few months.

Range of Motion

Because the unusual shoulder joint movement or a lack thereof can be both a contributor and a symptom of biceps tendinitis, manual therapy and various exercises will be used to improve it. Your therapist will teach you the exercises, and you will also need to perform a routine at home.

Muscle Strengthening

Shoulder and upper back muscles and their balanced strength are essential for proper and efficient shoulder movement. That's why strengthening those muscles is a vital part of most physical therapy treatment plans. It's crucial to follow the PT's plan and perform only recommended exercises to avoid additional injury and pain.

Manual Therapy

To complement the exercises, your physical therapist will use hands-on modalities such as massage and joint mobilization to improve the shoulder joint and surrounding muscle range motion, flexibility, and strength. These techniques can target areas that are difficult to treat on your own.

How Can Physical Therapy Help


Pain Management

Pain management is of the utmost importance and urgency when treating bicep tendinitis, so your therapist will use modalities such as heat and ice to reduce it. Often these are enough to avoid the need for various medications.

Functional Training

One of the things many patients don't take into consideration is that proper movement and body mechanics are essential for optimal function.

Physical therapists can assess movement quality and recommend and teach necessary corrections that will help decrease pain and help with flexibility.

It is important to follow these recommendations not to reverse physical therapy's improvements or worsen the condition.

Can this Injury or Condition be Prevented?

As always, avoiding a condition is easier than treating it later. While there are no guarantees, everyone can do a few things to reduce the risk of biceps tendinitis.

Can this Injury or Condition be Prevented?

A few easy-to-follow tips:

  • Avoid repetitive overhead movement. Lifting above the head or various sports activities may overwork the shoulder and increase the risk of biceps tendinitis. When not possible to avoid them, always do a proper warm-up and rest afterward.

  • Improve posture. Poor posture over time increases the risk of back, shoulder, neck, and arm injuries. Consult with a PT to see how you can improve your posture and avoid long-term damage.

  • Carry heavy objects carefully. Never lift or carry heavy things with just one hand or hold them away from your body. Keep your hands close and assess your strength properly.

  • Exercise your shoulder regularly. Include shoulder and rotator-cuff strengthening exercises into your routine. Consult your PT for the best exercises.

Final Thoughts

Bicep tendonitis is a common condition when the biceps muscle tendon gets inflamed, swells, and causes pain and reduced range of motion.

There are many potential causes, including aging, degenerative diseases, trauma, poor posture, and repetitive shoulder movement.

It is essential to recognize the symptoms, such as pain, stiffness, swelling, cracking, and shooting sensation, and immediately consult a doctor or physical therapist.

After diagnosis, physical therapy is one of the best treatment options as it addresses the core issue and helps recover fully and avoid surgery.

Physical therapy will include various exercises, manual therapy, heat and ice, and other modalities. You can find a location next to you and book an appointment with Miracle Rehab Clinic.

Depending on the individual case, you can expect full recovery from 6 weeks to a few months.

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