7 Best Physical Therapy Exercises for Bicep Tendonitis

Bicep tendonitis is a painful condition affecting the tendons that connect the biceps muscle to the shoulder and elbow, commonly seen in professional athletes and individuals performing repetitive overhead motions or abduction activities. Often caused by overuse, improper posture, or poor technique, it presents with symptoms such as anterior shoulder pain, swelling, and difficulty moving the arm, which can disrupt routine activities. Physical therapy for bicep tendonitis is a key component of conservative management, providing effective, nonsurgical methods to promote tissue healing, alleviate pain, and restore function. Focusing on targeted physical therapy exercises for bicep tendonitis addresses underlying issues such as tendon sheath swelling, fibrosis, and adhesions, ensuring faster and more sustainable recovery.

What is Bicep Tendonitis?

Bicep tendonitis, or primary biceps tendinitis, is the inflammation or irritation of the tendons located in the bicipital groove of the shoulder. This condition can progress into more severe issues, such as biceps tendinosis, rotator cuff tears, or even tendon rupture if left untreated. Secondary conditions like glenoid labrum injuries or subacromial impingement syndrome often complicate diagnosis and treatment.

Primary biceps tendinitis, which involves inflammation of the biceps tendon within the bicipital groove, accounts for approximately 5 percent of all cases of biceps tendinitis. This specific condition can cause significant discomfort and often requires targeted treatment strategies.

Radiologic examination techniques, such as ultrasound imaging, MRI arthrography, and X-rays, play a vital role in the differential diagnosis of bicep tendonitis. Physical examination tests, including the Yergason test, and an objective assessment by an orthopedic specialist further confirm the condition. Early intervention is crucial to prevent degenerative changes, fibrosis, or surgical complications, such as tendon rupture or biceps tendon sheath infection.

Common Causes of Bicep Tendonitis

Repetitive overhead motions, such as swimming, tennis, or painting, can strain the biceps tendons over time, leading to inflammation and irritation. Improper posture, particularly poor shoulder alignment, further increases tension on the biceps tendon, exacerbating the risk of injury. Overuse from frequent, strenuous activities without adequate rest is another common cause of tendon irritation. In some cases, bone spurs can develop and rub against the biceps tendon, contributing to inflammation and discomfort. Additionally, rotator cuff tears and secondary impingement often coexist with bicep tendonitis, amplifying symptoms and complicating recovery.

Bicep tendonitis is particularly common among athletes due to the repetitive overhead movements involved in their sports. Individuals who play baseball, tennis, golf, or swim are at a higher risk of developing this condition because these activities place continuous stress on the biceps tendon.

Symptoms of Bicep Tendonitis

Anterior shoulder pain, often localized in the front of the shoulder and aggravated by movement, is a hallmark symptom of bicep tendonitis. This pain is frequently accompanied by swelling and tenderness, as the tendon sheath may become inflamed or affected by bleeding. Reduced range of motion is another common issue, making abduction and overhead activities challenging and uncomfortable. Individuals may sometimes experience clicking or popping sounds due to tendon movement within the bicipital groove. Weakness in the affected arm further complicates daily tasks, such as lifting objects, significantly impacting routine activities and overall function.

Benefits of Physical Therapy Exercises for Bicep Tendonitis

Physical therapy exercises are a cornerstone in the recovery process for bicep tendonitis, offering a range of benefits beyond pain relief. These targeted movements help restore strength, improve flexibility, and address the underlying causes of the condition. By incorporating these exercises into a comprehensive treatment plan, individuals can achieve faster recovery, reduce inflammation, and regain functional mobility while minimizing the risk of future injuries.

Faster Recovery

Therapeutic exercises improve blood flow to the affected area, accelerating tissue healing and reducing recovery time. A combination of manual therapy and strengthening exercises ensures efficient rehabilitation.

Less Inflammation and Shoulder Pain

By improving muscle balance and reducing tension in the biceps tendon sheath, physical therapy exercises for bicep tendonitis help alleviate inflammation and pain in shoulder areas, particularly anterior shoulder pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections can complement these exercises when prescribed by an orthopedic surgeon.

Improved Muscle Balance and Strength

Physical therapy targets imbalances that result from improper posture, secondary impingement, or degenerative changes. Exercises like biceps curls and shoulder external rotation strengthen supporting muscles, reducing stress on the tendon.

Key Considerations Before Starting Exercises

When starting bicep tendonitis exercises, it is essential to follow a tailored, individualized plan designed by a healthcare provider. Working one on one with a doctor of PT ensures that your exercise routine is specifically customized to your needs, promoting safe and effective recovery. Begin with gentle movements and prioritize activity modification to avoid overloading the tendon and exacerbating symptoms. Safety considerations are crucial throughout the process, including avoiding any movements that cause pain, maintaining proper form to prevent further injury, and gradually increasing the intensity of exercises. An orthopedic specialist or physical therapist should always guide this progression for optimal results.

7 Physical Therapy Exercises for Bicep Tendonitis

Incorporating targeted physical therapy exercises for bicep tendonitis is crucial for relieving pain, reducing inflammation, and restoring strength and mobility. These exercises are specifically designed to support tissue healing and prevent future injuries while improving overall shoulder and arm function.

Biceps Curls

Biceps curls are a fundamental exercise for strengthening the biceps without placing excessive strain on the tendon. This controlled movement targets the muscles, improving arm stability and function. Regular incorporation of this exercise can address muscle imbalances caused by overuse or poor posture.

Step-by-step Instructions:

1. Hold a light dumbbell with your palm facing forward.
2. Slowly curl the weight toward your shoulder, engaging the biceps muscle.
3. Lower the weight back to the starting position with control.
4. Perform 2–3 sets of 10–12 repetitions.

Benefits:

• Strengthens the biceps without straining the tendon.
• Improves forearm and shoulder stability.
• Addresses muscle imbalances caused by overuse or improper posture.

Biceps Stretch

The biceps stretch helps relieve tension and improve flexibility in the biceps muscle and tendon. By elongating the muscle, it reduces the risk of adhesions and promotes better range of motion. This exercise is particularly effective in preventing stiffness and ensuring tendon recovery.

Step-by-step Instructions:

1. Extend your arm straight out to the side and press your palm against a wall.
2. Turn your body away from the wall slowly until you feel a stretch in the biceps.
3. Hold for 20–30 seconds and repeat 2–3 times.

Benefits:

• Enhances flexibility and relieves tension in the biceps.
• Prevents adhesions and fibrosis in the tendon sheath.

Shoulder Flexion

Shoulder flexion exercises focus on strengthening the muscles that support the shoulder joint, reducing the strain on the biceps tendon. These movements improve overall shoulder mobility, making everyday tasks easier and less painful. They are ideal for restoring functional strength after tendon irritation.

Step-by-step Instructions:

1. Use a resistance band, holding it at waist level.
2. Lift one arm straight ahead to shoulder height.
3. Lower it slowly to the starting position.
4. Repeat 8–10 times per arm.

Benefits:

• Targets supporting shoulder muscles.
• Reduces strain on the biceps tendon during routine activities.

Shoulder Internal Rotation Stretch

The shoulder internal rotation stretch strengthens the rotator cuff and surrounding muscles, enhancing shoulder stability. This exercise helps prevent secondary impingement by correcting muscular imbalances. It is especially useful for individuals who experience discomfort during routine shoulder movements.

Step-by-step Instructions:

1. Attach a resistance band to a stable surface.
2. Hold the band with your elbow bent at 90 degrees and pull inward.
3. Slowly return to the start.
4. Perform 10–12 repetitions.

Benefits:

• Strengthens the rotator cuff, enhancing shoulder mobility.
• Prevents secondary impingement caused by weak stabilizers.

Shoulder External Rotation

Shoulder external rotation exercises improve balance and coordination between the shoulder stabilizers. This movement reduces the risk of subacromial impingement and supports tendon healing by strengthening the external rotators. It is a vital exercise for maintaining shoulder joint integrity.

Step-by-step Instructions:

1. Similar to the internal rotation stretch, hold the band but rotate your arm outward.
2. Maintain a 90-degree elbow bend throughout.
3. Perform 10–12 repetitions.

Benefits:

• Balances shoulder joint stability.
• Reduces the risk of subacromial impingement syndrome.

Forearm Twists

Forearm twists strengthen the forearm and biceps tendons, improving grip and rotational movement. This exercise is beneficial for restoring functional strength, especially for tasks that require twisting or turning motions. It also helps reduce strain on the biceps during routine activities.

Step-by-step Instructions:

1. Hold a light dumbbell or a small stick with your elbow bent.
2. Slowly rotate your forearm, alternating between palm-up and palm-down positions.
3. Repeat 12–15 times for 2–3 sets.

Benefits:

• Strengthens forearm and biceps tendons.
• Improves functional movement for routine activities.

Shoulder Circle Crossover

The shoulder circle crossover improves shoulder mobility and relieves stiffness caused by tendon inflammation. By promoting smooth circular motions, this exercise enhances flexibility and reduces tension in the muscles. It is a gentle yet effective way to support recovery and restore range of motion.

Step-by-step Instructions:

1. Extend your arms outward and make small circular motions.
2. Gradually increase circle size and reverse direction.
3. Perform for 20–30 seconds.

Benefits:

• Improves shoulder mobilization and flexibility.
• Relieves stiffness caused by tendon inflammation.

Exercises to Avoid with Bicep Tendonitis

While physical therapy exercises are essential for recovery, certain movements can aggravate bicep tendonitis and should be avoided. These exercises often place excessive strain on the biceps tendon or shoulder joint, increasing the risk of further injury or delaying recovery. Knowing which activities to steer clear of is crucial to ensuring a safe and effective healing process.

Overhead Lifting

Overhead lifting places significant strain on the biceps tendon, particularly during abduction and overhead activities. This repetitive motion can exacerbate inflammation and delay recovery. Avoiding this exercise allows the tendon to heal without additional stress.

Overhead Shoulder Press

Overhead shoulder presses place significant stress on the biceps tendon and shoulder joint, heightening the risk of tendon rupture or secondary impingement. The repetitive upward motion involved in this exercise intensifies strain, making it unsuitable for those recovering from bicep tendonitis. Opting for gentler alternatives can help promote healing while reducing the risk of further injury.

Shoulder Shrugs

Shoulder shrugs can overwork the upper trapezius and biceps tendon, aggravating symptoms of tendonitis. This exercise often creates unnecessary tension in the shoulder area, worsening pain and inflammation. Avoiding shoulder shrugs helps reduce stress on the affected region.

Push-ups

Push-ups require significant activation of the shoulder and biceps, which can overload the tendon and hinder tissue healing. This weight-bearing movement also strains the shoulder joint, increasing discomfort. Eliminating push-ups from your routine prevents further irritation of the tendon.

Heavy Weights

Lifting heavy weights adds undue stress to the already inflamed tendon, making it harder for the tissue to recover. The risk of tendon rupture increases with excessive weight, particularly during improper movements. Focus on lighter resistance exercises to facilitate healing and rebuild strength gradually.

At Peak Endurance Performance & Physical Therapy, we specialize in helping athletes and individuals recover from conditions like bicep tendonitis through tailored, science-backed treatment plans. Our expert team provides personalized physical therapy programs to reduce pain, restore mobility, and enhance overall performance. Whether you’re dealing with the challenges of repetitive overhead motion or seeking relief from primary biceps tendinitis, we offer a comprehensive approach to recovery, incorporating advanced techniques and compassionate care to help you achieve your peak potential.

Conclusion

Physical therapy exercises play a crucial role in recovering from bicep tendonitis, offering relief from pain and inflammation while enhancing strength and flexibility. Following a personalized treatment plan designed by a professional ensures a safe and effective recovery, reducing the risk of complications such as tendon rupture or the need for surgical intervention. Taking a proactive approach to rehabilitation empowers individuals to regain function and prevent future injuries.

FAQs

Does physical therapy help bicep tendonitis?

Yes, physical therapy for bicep tendonitis promotes tissue healing, reduces pain, and prevents future injuries through targeted therapeutic exercises.

What is the best exercise for bicep tendonitis?

Exercises like biceps curls, biceps stretches, and shoulder external rotation are highly effective for strengthening and relieving tension in the tendon.

What movements should you avoid with bicep tendonitis?

Avoid movements like overhead lifting, push-ups, and heavy weightlifting, as these can worsen symptoms and delay recovery.