When Shoulder Pain Means Bicipital Tendonitis
Many people feel pain in the front of their shoulder, especially when they lift their arm or reach overhead. This kind of pain can make everyday tasks hard, like getting dressed or putting something on a shelf. One common cause of front shoulder pain is called bicipital tendonitis as an Austin, TX physical therapist can explain. This condition affects a tendon in your shoulder that helps you move your arm. Knowing what bicipital tendonitis is and how it starts can help you understand your pain and what might be causing it.
What Is Bicipital Tendonitis?
Bicipital tendonitis is when the long head of the biceps tendon becomes irritated or inflamed. Your biceps muscle has two parts, or “heads.” One part connects near the top of your shoulder. This tendon runs through a groove in the front of your shoulder and helps you bend your elbow and rotate your arm. When this tendon is overused or strained, it can become swollen and painful. The pain is often felt right in the front of the shoulder, especially during movement.
This tendon plays an important role in many daily actions. Every time you lift something, reach overhead, or turn your arm, the biceps tendon helps stabilize and guide the movement. That’s why, when it becomes inflamed, even simple tasks can start to hurt.
Habits and Activities That Lead to It
Bicipital tendonitis often develops over time. Many people don’t realize that their daily habits are putting extra stress on their shoulder. One common cause is doing the same overhead motion again and again. This might happen in sports like swimming, tennis, or baseball. It can also happen at work if you reach overhead a lot or lift things often.
Poor posture is another key factor. If you sit or stand with rounded shoulders and a forward head position, it changes how your shoulder moves. Over time, this puts extra strain on the biceps tendon. Even simple things like carrying a heavy bag on one side, slouching at your desk, or holding your phone between your shoulder and ear can make the problem worse.
A sudden increase in activity can also lead to this condition. This is common in people who jump back into exercise after taking a break. Without giving your shoulder time to adjust, the tendon can become irritated quickly. Aging also plays a role. As we get older, our tendons naturally become less flexible and more prone to wear and tear. This makes it easier for inflammation to occur, even with smaller movements.
Muscle weakness or imbalance around the shoulder can also contribute. If the muscles that support the shoulder aren’t working well, the biceps tendon may end up doing more than its share. This can lead to overuse and inflammation over time.
Symptoms of Bicipital Tendonitis
The pain from bicipital tendonitis is usually felt right in the front of the shoulder. It might start as a dull ache and become sharper during certain movements. People often notice it when lifting something or reaching up high. Turning the palm up or down, like when using a screwdriver, can also cause discomfort.
The shoulder might feel tender when you press on the front of it. Some people feel a snapping or clicking sensation when moving their arm, especially if the tendon shifts out of place. The pain may get worse at night or after doing certain activities. You might feel like your shoulder gets tired faster or feels weaker than usual. Over time, the discomfort can make you avoid using that arm as much, which can lead to even more weakness and stiffness.
Daily Life with Bicipital Tendonitis
Living with bicipital tendonitis can affect many parts of your daily routine. Simple things like putting on a shirt, brushing your hair, or fastening a seatbelt can suddenly become painful. Driving may be uncomfortable, especially when reaching for the steering wheel or gear shift. Even carrying groceries or picking up a child can trigger sharp pain in the shoulder.
People often find they need to change how they move or avoid certain tasks. This can lead to frustration and make them feel limited in their daily life as we have seen countless times at Move Empower Concierge Physical Therapy. Sleep is also often affected. Finding a comfortable position can be hard, especially if you lie on the painful shoulder. Poor sleep can make the pain feel worse and slow down healing.
For those who enjoy sports or workouts, this condition can be very discouraging. You may not be able to lift weights, play tennis, or swim without discomfort. Over time, avoiding these activities can affect your strength and overall health. Emotionally, it can also take a toll. People sometimes feel anxious or upset about not being able to use their arm normally. It can make them feel older or less capable, even if they are otherwise healthy and active.
How It Connects to Other Shoulder Problems
Bicipital tendonitis doesn’t always happen on its own. It often appears alongside other shoulder problems. One common issue is shoulder impingement, where tendons get pinched during movement. This can lead to inflammation in the biceps tendon. Another is rotator cuff tendinopathy, where nearby muscles are also irritated or torn. When these problems are present, the shoulder may feel even more painful or weak.
Sometimes, the biceps tendon becomes unstable or slips out of its groove. This can cause a snapping feeling in the front of the shoulder. It may also mean that other parts of the shoulder, like the labrum or ligaments, are not supporting the joint well. Because of these connections, pain in the front of the shoulder should always be taken seriously. It may be a sign that more than one part of the shoulder needs attention.
Most Commonly Asked Questions About Bicipital Tendonitis
We often seen this condition as part of our mobile physical therapy practice, so we have compiled a list of the most frequently asked questions we encounter. Check them out below, and then schedule a FREE discovery session today!
Where is the pain located?
The pain from this condition is most often located in the front of the shoulder, just below the bony top. Many people can point to a specific tender spot in this area. The discomfort may stay right there or spread slightly down the upper arm. It usually doesn’t affect the neck or elbow directly. Because of its location, the pain is often confused with other shoulder problems.
Can posture really make it worse?
Yes, poor posture is a major contributing factor. When your shoulders slump forward and your head shifts out in front of your body, it narrows the space the tendon has to move. This increases friction every time you lift your arm. Over time, that added stress can cause pain and swelling in the tendon. People who sit at desks for long hours or use phones frequently often don’t realize how much their posture affects their shoulders.
Does it come on suddenly or gradually?
In most cases, the pain builds up slowly. It may start as a small ache that comes and goes. Eventually, it can become more noticeable and limit your movement. Sudden pain can occur if you lift something heavy or make a quick, awkward movement, but most cases of bicipital tendonitis are due to long-term overuse.
Why does it hurt more at night or after activity?
After using the arm during the day, inflammation in the tendon can increase. That swelling causes more pressure and pain. At night, lying on the affected shoulder or keeping the arm in one position can also make the discomfort worse. Many people notice the ache is strongest when they try to relax or sleep, even though the problem started with movement.
Can it make the arm feel weak?
Yes, when the tendon is irritated, it affects how the shoulder muscles work. You may find it harder to lift objects or do things that used to be easy. The weakness often comes from pain and muscle guarding—not from actual damage to the biceps muscle itself. Still, this change in function can be frustrating and affect confidence in daily tasks.
Is it linked to other shoulder problems?
Bicipital tendonitis rarely shows up on its own. It’s often found along with rotator cuff problems or shoulder impingement. Because the biceps tendon travels through the shoulder joint, anything that changes the way the joint moves can impact the tendon. This makes it important to consider the whole shoulder when looking at the cause of pain, not just the tendon itself.
Can everyday tasks trigger it?
Even if you don’t play sports, everyday tasks can still cause trouble. Reaching overhead into cabinets, lifting groceries, cleaning windows, or carrying children can all put pressure on the tendon. It’s the repetition of these movements, not just the type of activity, that leads to overuse.
What kind of pain does it cause?
The pain is typically felt in the front of the shoulder and may worsen with lifting or reaching. Many people say it feels like a dull ache at rest that turns into a sharper pain with movement. It often becomes more intense during activities that involve the front of the shoulder or when rotating the arm.
Can it change how your shoulder moves?
Yes, shoulder motion often changes to avoid pain. When this happens, other muscles try to compensate, which can lead to new areas of tension or soreness. Over time, these changes may limit flexibility and affect how easily you can move your arm.
Is it more common as we get older?
Age increases the chances of tendon wear. In fact, one published study found that the chance of developing biceps tendinopathy increases steadily with age and is nearly universal in people over 85 who have shoulder pain. This happens because tendons lose strength and elasticity over time, making them more vulnerable to overuse and injury.