Understanding bicep tendon anatomy helps you train safely and understand why certain injuries occur. Your biceps has tendons at both ends—each with different characteristics and injury patterns.
Proximal Biceps Tendons (At the Shoulder)
At the shoulder end, the biceps has two tendons (one for each head):
Long head tendon:
• Originates at the supraglenoid tubercle
• Travels through the bicipital groove of the humerus
• Held in place by the transverse humeral ligament
• More commonly injured than short head tendon
Short head tendon:
• Originates at the coracoid process
• Shorter, more direct path
• Less commonly injured
Distal Biceps Tendon (At the Elbow)
At the elbow, both heads merge into a single tendon:
Distal biceps tendon:
• Formed by the merger of both heads
• Attaches to the radial tuberosity (a bump on the radius bone)
• Essential for elbow flexion AND forearm supination
• When torn, causes significant functional loss
Tendon Function
Tendons serve as the connection between muscle and bone:
Force transmission: When your bicep muscle contracts, the force is transmitted through the tendons to move your bones.
Elastic energy: Tendons store and release elastic energy during movement.
Proprioception: Tendons contain sensory receptors that help your brain know where your arm is in space.
Common Tendon Issues
Proximal bicep tendonitis:
• Inflammation of the long head tendon at the shoulder
• Common in overhead athletes and lifters
• Causes front-of-shoulder pain
Distal bicep tendonitis:
• Inflammation at the elbow attachment
• Less common than proximal
• Causes pain in the crook of the elbow
Tendon tears:
• Can occur at either end
• Distal tears often require surgery
• Proximal tears may be managed conservatively
Protecting Your Tendons
Warm up: Tendons need blood flow before heavy loading.
Progress gradually: Tendons adapt slower than muscles. Rapid weight increases can overwhelm tendons.
Don't ignore pain: Tendon pain is a warning sign. Address it early.
Include recovery: Tendons need rest between heavy sessions.
The Bottom Line
Your biceps attach via tendons at the shoulder (two tendons, one per head) and elbow (single combined tendon). The long head tendon at the shoulder is most vulnerable to injury. Protect your tendons with proper warm-up, gradual progression, and attention to warning signs of overuse.