Biceps Tendinopathy: Causes, Symptoms & How Physiotherapy Can Help
Biceps tendinopathy is a common condition that affects the long head of the biceps tendon, which runs from the upper arm into the front of the shoulder. It can cause persistent pain, weakness, and a nagging discomfort that interferes with daily activities, from lifting shopping bags to playing sports.
The good news? Physiotherapy offers an effective, evidence-based path to recovery.
What Is Biceps Tendinopathy?
Biceps tendinopathy is a degenerative condition of the tendon, not an acute tear. It typically results from overuse, poor biomechanics, or shoulder instability, leading to micro-tears, inflammation, and thickening of the tendon over time.
Common Causes:
Repetitive overhead activities (e.g., tennis, swimming, painting)
Poor posture and scapular control
Shoulder impingement or rotator cuff issues
Weak rotator cuff and shoulder stabilisers
Symptoms to Look Out For:
Pain in the front of the shoulder and upper arm
Discomfort with lifting, reaching overhead, or pulling movements
Tenderness over the biceps groove
Weakness or fatigue with repetitive arm use
Clicking or catching in some cases
How Physiotherapy Can Help
A physiotherapist plays a key role in diagnosing, managing, and treating biceps tendinopathy through a combination of targeted strategies:
1. Pain Management & Load Modification
We begin by identifying and modifying the activities that aggravate the tendon.
Treatment may include:
Temporary activity restriction (avoiding heavy lifting or overhead work)
Ice therapy to reduce inflammation
Taping or bracing if needed for support
2. Manual Therapy
Hands-on techniques to address contributing factors such as:
Shoulder joint stiffness
Tight pectoral or upper trapezius muscles
Poor scapular movement and posture
3. Progressive Loading & Rehab Exercises
This is the core of treatment. Tendons need to be loaded gradually to promote healing and strengthen collagen fibers.
Examples of exercises include:
Isometric elbow flexion holds
Eccentric biceps curls
Scapular stabilisation work
Rotator cuff strengthening
Exercises are progressed over time, from pain-tolerant movements to functional strength training.
4. Postural & Movement Retraining
Many cases involve poor shoulder mechanics or postural control. We help retrain:
Scapular positioning during movement
Core engagement during overhead activities
Ergonomic corrections at work or during sport
5. Return-to-Activity Guidance
We’ll help guide a safe return to sport, gym, or work with a graded plan to reduce re-injury risk.
When to See a Physiotherapist
If you’ve had shoulder or upper arm pain for more than 2–3 weeks, or if you notice weakness, clicking, or night pain, it’s time for a professional assessment.
Left untreated, biceps tendinopathy can lead to chronic pain or even tendon rupture.
Final Word from the Physio
Biceps tendinopathy is very treatable with the right physiotherapy approach. With personalised rehab, hands-on care, and education, we’ll help you move confidently, pain-free, and stronger than before.
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