The biceps muscle goes from the shoulder to the elbow on the front of the upper arm. Two separate tendons connect the upper part of the biceps muscle to the shoulder.

The main proximal tendon is the long head of the biceps. It connects the biceps muscle to the top of the shoulder socket, the glenoid. It also blends with the cartilage rim around the glenoid, the labrum. The labrum is a rim of soft tissue that turns the flat surface of the glenoid into a deeper socket. This arrangement improves the fit of the ball that fits in the socket, the humeral head. Beginning at the top of the glenoid, the tendon of the long head of the biceps runs in front of the humeral head. The tendon passes within the bicipital groove of the humerus and is held in place by the transverse humeral ligament. This arrangement keeps the humeral head from sliding too far up or forward within the glenoid.

The short head of the biceps connects on the coracoid process of the scapula (shoulder blade). The coracoid process is a small bony knob just in from the front of the shoulder. The lower biceps tendon is called the distal biceps tendon. The word distal means the tendon is further down the arm. The lower part of the biceps muscle connects to the elbow by this tendon. The muscles forming the short and long heads of the biceps stay separate until just above the elbow, where they unite and connect to the distal biceps tendon.


Biceps tendonitis, also called bicipital tendonitis, is inflammation in the main tendon that attaches the top of the biceps muscle to the shoulder. The most common cause is overuse from certain types of work or sports activities. Biceps tendonitis may develop gradually from the effects of wear and tear, or it can happen suddenly from a direct injury. The tendon may also become inflamed in response to other problems in the shoulder, such as rotator cuff tears, impingement, or instability

Patients who have biceps tendonitis generally report the feeling of a deep ache directly in the front and top of the shoulder. The ache may spread down into the main part of the biceps muscle. Pain is usually made worse with overhead activities. Resting the shoulder generally eases pain. The arm may feel weak with attempts to bend the elbow or when twisting the forearm into supination (palm up). A catching or slipping sensation felt near the top of the biceps muscle may suggest a tear of the transverse humeral ligament.


Graston technique is a great therapy which not only detects the presence of an inflamed tendon, but also is very effective in the treatment of it. Please see the therapies offered tab for more information about Graston technique. Chiropractic adjustment can play a driving force in the correction due to the ability to increase range of motion. When the shoulder is misaligned, extra strain can be placed on the muscles surrounding the shoulder. Ergonomics can play a big factor in the prevention of this ailment as chronic stress and repetitive motion disorders are the most common reason that biceps tendonitis forms in the first place. Heat is a common therapy used at home, but should only be used with the understanding that it will likely not get rid of the inflamed tendon. Muscle are like Rubber Bands. They stretch and become more flexible when heated. However, they will return to the normal position when they cool. Therapies such as Graston technique, rapid release and massage therapy can permanently address the knot and the prevention of more. It is usually advised that ice is applied to the area at least 2x daily in 15min intervals after therapy.