Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. eBicep is not a medical provider and cannot diagnose, treat, or provide medical recommendations. Always consult a qualified healthcare professional for diagnosis and treatment of any injury or medical condition. eBicep and its authors assume no liability for any actions taken based on the information provided.
That nagging pain in the front of your shoulder or at your elbow that gets worse when you curl—that's likely bicep tendonitis. The good news: most cases resolve with proper conservative treatment. Let me walk you through what's happening and how to address it.
What Is Bicep Tendonitis?
Tendonitis means inflammation of a tendon—the thick fibrous tissue connecting muscle to bone. Your biceps has tendons at both ends:
Proximal biceps tendon: At the shoulder, where the long head of your biceps attaches to your scapula (shoulder blade). This is where most bicep tendonitis occurs.
Distal biceps tendon: At the elbow, where your biceps attaches to the radius bone. Less common but happens, especially in lifters.
Tendonitis typically develops from repetitive stress causing micro-tears faster than your body can repair them. Over time, this leads to inflammation, pain, and weakness.
Symptoms of Bicep Tendonitis
Proximal (shoulder) symptoms:
• Aching pain at the front of your shoulder
• Pain that worsens with overhead movements
• Tenderness when pressing the front of the shoulder
• Pain during bicep curls or pulling movements
• Weakness when lifting with arm extended
• Possible clicking or snapping sensation
Distal (elbow) symptoms:
• Pain in the crook of your elbow
• Pain when curling or supinating (turning palm up)
• Tenderness at the inner elbow
• Weakness during curling movements
• Possible swelling at the elbow
What Causes Bicep Tendonitis?
Overuse: Too much volume, too frequently, without adequate recovery. The most common cause in lifters.
Poor form: Excessive shoulder involvement during curls, swinging weights, or hyperextending elbows.
Rapid progression: Adding weight or volume too quickly for tendons to adapt. Tendons adapt slower than muscles.
Age: Tendons become less elastic and more prone to injury as we age.
Other shoulder issues: Rotator cuff problems or shoulder impingement can contribute to proximal bicep tendonitis.
Home Treatment Protocol
Phase 1: Acute Phase (First 1-2 weeks)
Relative rest: Avoid activities that cause pain, but don't immobilize completely. Light movement promotes healing.
Ice: 15-20 minutes several times daily, especially after any activity. Reduces inflammation.
NSAIDs: Over-the-counter anti-inflammatories (ibuprofen, naproxen) can help with pain and inflammation. Follow package directions and consult a pharmacist if you have any health conditions.
Modify, don't eliminate: If curls hurt, stop curling. But you might be able to do other exercises that don't aggravate the tendon.
Phase 2: Recovery Phase (Weeks 2-6)
Gradual loading: Start with isometric exercises (contracting against resistance without movement). Progress to light isotonic exercises (movement with resistance).
Eccentric exercises: Slow, controlled lowering movements have strong research support for tendon healing. Example: slowly lowering a light weight during curls.
Address contributing factors: Work on shoulder mobility, rotator cuff strength, and correct any form issues.
Phase 3: Return to Training (Weeks 6+)
Progressive return: Start with 50% of your previous weight and volume. Increase by 10-15% per week if pain-free.
Listen to your body: Mild discomfort is acceptable; actual pain is not. Back off if symptoms return.
When to See a Doctor
Seek medical evaluation if:
• Pain persists beyond 2-3 weeks despite home treatment
• You heard or felt a "pop" at the time of injury
• Significant weakness or inability to use the arm
• Visible deformity or significant bruising
• Symptoms worsen despite rest
• You're unsure about the diagnosis
A physician can rule out more serious conditions like tendon tears, order imaging if needed, and potentially refer you to physical therapy.
Prevention: Avoiding Recurrence
Proper warm-up: Light cardio and dynamic stretching before lifting. Never curl cold.
Progressive overload: Increase weight and volume gradually. Tendons need time to adapt.
Form check: Eliminate swinging, excessive shoulder involvement, and elbow hyperextension.
Volume management: More isn't always better. Include deload weeks and adequate rest days.
Address weaknesses: Rotator cuff strength, shoulder stability, and overall upper body balance matter.
The Bottom Line
Bicep tendonitis is frustrating but usually resolves with conservative treatment over 4-8 weeks. The key is relative rest followed by gradual, progressive loading. Don't rush back to full training—tendons heal slower than you'd like.
If home treatment isn't working or you're unsure about your condition, consult a healthcare professional. There's no substitute for proper medical evaluation.