The biceps tendon is what connects your biceps muscle to the bone of the shoulder blade. If that tendon becomes inflamed or strained, it can cause a condition known as biceps tendinitis. Biceps tendinitis is an overuse injury that often occurs due to repeated arm motions, such as overhead movements. While biceps tendinitis usually occurs due to continual overuse of the biceps tendon, it can also be caused by a sudden, serious strain to the tendon. 

Shoulder pain is common with biceps tendinitis and, if left untreated, can significantly limit your ability to function. Let’s look at some physical therapy exercises that can improve biceps tendinitis, plus which moves to avoid.

Exercises for biceps tendinitis

With biceps tendinitis, gentle exercise can help you stretch and strengthen your injured biceps tendon. It’s important to do these exercises gently to make sure you aren’t going to reinjure yourself. If you start feeling pain while performing any of these exercises, stop them right away. Additionally, make sure to give yourself plenty of rest time between exercise repetitions, as overuse can also worsen your injury.

• Biceps curls — Begin in a standing position and grab a light weight, such as a small dumbbell. Allow your arm to rest at your side with your palm facing forward. Keeping your upper arm parallel to your torso, lift the dumbbell at your elbow and then slowly lower your arm back down. Repeat this 10 times for one set. Do up to three sets throughout the day, resting between each one.
• Biceps stretch — Begin by standing about 6 inches away from a wall. You should be facing the wall. Raise your arm to the side until your hand is in line with your shoulder; then slowly move your hand forward until your thumb touches the wall. Your palms should be facing downward. Keep that arm steady while you twist your body to look away from your raised hand. You should feel a slight stretch in your biceps. Hold for 15 seconds, and then let your arm return to its original position. Repeat this exercise three times, resting between each one. Be careful not to overstretch your shoulder with this exercise, because this can lead to unnecessary strain on the tendon.
• Shoulder flexion — Begin with your arm at your side and your palm facing your thigh. Slowly, raise your arm, keeping it straight at the elbow until your fingers are pointed up at the ceiling. Hold for five seconds, and then return to the original position. Repeat up to 10 times. Make sure not to push your shoulder backward as you raise it, as this can cause unnecessary strain on the biceps tendon.
• Shoulder internal rotation — For this exercise, you will need a resistance band or a long towel. Begin by holding one end of the band behind your head with your noninjured arm. With your injured arm, reach behind your rib cage at the level of your lower back and grab onto the band. Gently lift the band with your noninjured arm to stretch your injured arm up toward your shoulder blades. Stop before the stretching causes any pain and hold for 30 seconds. Repeat this exercise once. You can do a set of two up to twice throughout the day.
• Shoulder external rotation — For this exercise, you will need a resistance band or a long towel. Begin by holding your exercise band out in front of you at waist height. Your elbows should be at your sides at a 90-degree angle with your palms facing downward. Gently widen the space between your hands, pulling the band apart while keeping your elbows at your sides. When you feel a gentle stretch in your arm, slowly bring your hands back toward the center until they’re in their original position. Repeat 10 times. You may do this set of exercises up to three times throughout the day.
• Forearm twists — Begin by standing with your arms at your sides. Bend your elbow at a 90-degree angle, keeping your elbows at your sides and your palms facing downward. Turn your palms over so that they are now facing upward and hold for five seconds. Then rotate downward so your palms are facing the floor and hold for five seconds. Repeat this set 10 times. You may do this up to three times throughout the day.

The goal of these exercises isn’t to build huge muscles but to provide gentle improvement to help heal and strengthen your injured tendon. These exercises are meant specifically for biceps tendinitis. If you’re having other shoulder or arm issues, consult your health care provider before attempting them.

Exercises to avoid with biceps tendinitis

Since biceps tendinitis is often caused by overuse and repetitive movements, certain activities or positions may interfere with the healing process. Here are a few common movements you should avoid to help your biceps tendon heal faster:

• Repetitive overhead movement — Lifting or stretching above your head can overwork the shoulder and increase symptoms of biceps tendinitis. You may need to temporarily stop certain sports activities that require a lot of throwing or shoulder movement. If it’s not possible to avoid these movements altogether, always take the time to warm up properly, rest afterward and stop the activity immediately if it is increasing your pain.
• Poor posture — Over time, poor posture can increase your risk of back, neck, shoulder and arm injuries. Try to keep your posture elevated to better support your shoulder and arm movements. A physical therapist or movement specialist can evaluate your posture and help you correct it so you reduce the risk of reinjuring yourself.
• Carrying heavy objects — Lifting or carrying heavy objects with just one hand or holding them away from your body while you’re carrying them can strain your biceps tendon and cause further injury. If you must carry heavy objects, keep your hands close to your body and make sure not to overdo it.
• Overexercising your shoulder — Overworking your shoulder can aggravate your biceps tendinitis and make it worse. While stretching and strengthening your shoulder muscles is an integral part of the recovery process, overdoing it will make things worse. Make sure to listen to your body, and if any exercise is causing increased pain, stop doing it immediately and consult your health care provider. 

These movements can’t always be avoided, but it’s important to limit strenuous arm and shoulder activities while your biceps tendon heals. Making sure to do these movements properly once you’re healed can also reduce your risk of reinjury. 

Causes and symptoms of biceps tendinitis

Biceps tendinitis most often occurs due to general wear and tear on the biceps tendon throughout daily activities. As you age, the wear and tear on your tendons increases and is more likely to develop into tendinitis. While biceps tendinitis frequently affects professional athletes, there are a number of risk factors that come into play, such as:

• Age
• Repeated overhead motions in your daily activities
• Participating in sports or other physical activities
• Arthritis
• Smoking

These can all be contributing factors for biceps tendinitis and may increase your risk of straining your biceps tendon.

With biceps tendinitis, there are a number of different symptoms you may experience. Here are a few of the most common ones:

• Pain or tenderness in the front of the shoulder that worsens with overhead lifting or activity
• Pain or achiness that moves down the upper arm bone
• An occasional snapping sound or feeling in the shoulder
• Pain when you move the upper part of the arm, such as the shoulder or elbow
• Weakness in the arm
• Tenderness along the front of the shoulder

Biceps tendinitis can make it difficult for you to do even simple tasks that require the movement of your shoulder and arm. However, there are treatment options available. Our licensed physical therapists at Lattimore PT are highly trained in a number of physical therapy techniques that can specifically target the biceps tendon and surrounding tissue to help you rehabilitate your shoulder. 

If you’re ready to take control of your biceps tendinitis and get back to doing the activities you love, contact our team today for more information or to schedule an initial appointment.