Biceps tendon injuries and damage

Pain that occurs as a result of inflammation of the tendon of the long head of the biceps is most often localized in the front of the shoulder.

The most common cause of biceps tendon injuries and damage is subacromial collision syndrome or impingement syndrome, which you can read more about HERE.

In short, when you raise your arm above your head, due to the specific structure of the shoulder joint in which each of the structures that make it up must function perfectly to have a full range of active and passive movement, even in physiological circumstances there is a collision between components of coracoacromial arch and large tubercle nodules located on the upper part of the humerus, for which most of the shoulder girdle muscles are originated. In case one of these structures is of abnormal structure, damage occurs which, in addition to the rotator cuff tendon, will also damage the long biceps tendon. In this case, we are talking about the so-called. “Secondary tendinitis”.


From other sources on this topic

Does your shoulder hurt while raising your arms above your head?

Primary tendonitis of the long head of the biceps occurs as a consequence of the structure of the intertubercular groove through which the tendon of the long head of the biceps passes, which is shown in the picture above. This groove is quite narrow, and often becomes even narrower due to disturbances of some of the surrounding structures (inflammation of the adjacent bursa, the formation of bony protrusions in the groove itself, deformity of the ligament covering the groove), which results in increased friction of the tendon against the bone. inflammation of the tendon sheath and damage to the tendon which, if left untreated or inadequately treated, results in complete rupture.


Pain that occurs as a result of inflammation of the tendon of the long head of the biceps is most often localized in the front of the shoulder, and occurs when raising the arm above head level. Very often there is a traumatic event or work in which you keep your hand above your head most of the time. If there is instability of the tendon, when rotating in the shoulder joint, it is possible to feel the “jump” of the tendon.

Typical shortening of muscle length after biceps tendon rupture


Biceps rupture, fortunately, is fairly easy to identify based on the clinical picture, and the final proof is the ultrasound finding. Patients with biceps rupture report a specific traumatic event after which the pain began. The upper arm is typically deformed in such a way that the muscle is markedly shortened due to tendon retraction. The patient cannot bend the arm at the elbow. On palpation, local tenderness and soreness occur on the projection of the intertubercular groove. Magnetic resonance imaging may also be helpful.

One of the typical clinical tests to prove damage to the biceps tendon is the Speed ​​test, in which a patient from the position of the arm extended at the elbow tries to bend the arm against the resistance provided by the doctor, causing pain in the projection of the intertubercular groove.


The treatment of biceps tendinitis depends on whether it is primary or secondary tendinitis. In primary tendinitis, treatment is performed with nonsteroidal antirheumatic drugs with targeted physical therapy, while in secondary tendinitis, the primary cause of the problem is impingement syndrome, so this type of tendinitis is treated in the same way as impingement syndrome.

In short

Polyclinic Ribnjak is a unique institution in the Republic of Croatia. It unites different branches of medicine, all in order to stay true to its slogan “Health and Beauty. Together”. Orthopedics, advanced sports diagnostics, functional and kinesiological rehabilitation, cosmetic surgery and treatments are the services we provide on a daily basis, professionally and in accordance with the latest professional standards.


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