Biceps tendinitis is inflammation or partial tearing of the long head of the biceps where it attaches in the shoulder; complete rupture produces a characteristic "Popeye" deformity. Symptoms can develop gradually or after a specific injury, so early evaluation matters when function starts to decline.
Most patients with biceps tendinitis improve with conservative care: rest from aggravating activity, anti-inflammatory medication, physical therapy, and sometimes an ultrasound-guided steroid injection around the tendon. Many tears of the biceps tendon at the shoulder are also treated without surgery, because the arm usually keeps most of its strength. Surgery, most often a biceps tenodesis, is considered when pain persists, for some complete tears in active patients, or when another shoulder problem needs repair at the same time.
Below, we walk through the anatomy involved, the symptoms and causes we most often see, how we diagnose biceps tendinitis and biceps tendon tears, and the full range of treatment options, from the simplest to the most involved.