HomeHealth articlesphysical therapyWhat Common Conditions Affect the Biceps?

The biceps are involved in tasks like lifting and sports activities. This article explains what the common biceps injuries and their treatment are.

Medically reviewed by

Dr. Atul Prakash

Published At October 31, 2022
Reviewed AtJuly 17, 2023

What Is Biceps?

The biceps is a large, thick muscle on the upper arm's ventral side. Biceps brachii is another name for it. A small head and a long head make up the muscle. The long head of the biceps brachii is on the lateral side, whereas the short head is on the medial side. The biceps brachii is a muscle that functions across three joints: the glenohumeral, elbow, and radio-ulnar joints.

What Common Conditions Affect the Biceps?

Lifting, throwing sports, and racket use in sports like baseball and cricket, badminton and tennis, as well as gesturing, require the use of the biceps. As a result, biceps tendinopathy is a very common problem in this muscle. Physical injuries or repetitive activity are the most common causes.

The following are some of the more frequent biceps disorders:

  • Strain in biceps brachii muscle.

  • Partially torn tendons affect either the proximal or distal tendon around the elbow. In addition to physical trauma, partial tears can be caused by tendon degeneration due to age or repetitive use.

  • When a biceps tendon ruptures and separates from the scapula or, less usually, the elbow, known as a complete tendon tear.

  • Inflammation of the tendon at the point where it meets with bone is known as insertional tendonitis.

What Is the Common Treatment for Biceps Injury?

The majority of biceps injuries recover on their own without the need for surgery. Acute injuries can be addressed with a therapy technique called the POLICE Principle for the first 48 to 72 hours. The POLICE priniciple has been described below:

Police (Protection, Optimal Loading, Ice Compression, and Elevation) - It is an acronym that stands for protection, optimal loading, ice compression, and elevation. It encourages and directs safe and effective loading in the treatment of acute soft tissue injuries. This principle is the modified first aid method that helps in addressing musculoskeletal injuries. The POLICE prinicpal plays an inportant role in the following:

1) Acute or recent injuries for the initial period of three days.

2) It is used to manage muscle strains or joint pain.

3) It can be used as a primary treatment for any types of injuries.

4) It helps in quick recovery from pain.

The goals of the POLICE prinicipal are listed below:

1) Protection:

Protection highlights the significance of preventing additional tissue injury but does not mean indefinite immobilization. This may entail using crutches to safeguard an injured lower extremity while doing daily activities. Protect could also refer to getting the proper rest to heal the ailment.

2) Optimal Loading:

Because bone, tendon, ligament, and muscle require some stress to induce healing, optimal loading will help to speed up the process. Mechanotherapy intervention, which comprises a wide range of manual approaches now accessible, is used to provide optimal loading. Crutches, braces, and supports, which have historically been associated with rest, may, paradoxically, play a larger role in modulating and controlling appropriate loading in the early stages of rehabilitation. Edema can be managed with the correct amount of activity. The calf muscles, for example, help to transport swelling up the body against gravity in the ankle. This could be avoided by complete rest. Loading may not always be essential for serious fractures that require surgery.

3) Ice-Compression- Elevation:

Ice Therapy:

Ice therapy, also known as cryotherapy, slows tissue metabolism and constricts blood vessels. This physiological alteration slows and avoids additional swelling, which is important to keep in mind when beginning active range of motion exercises after a period of rest. Ice also slows the transmission of nociceptive neural inputs to the brain, reducing pain and spasms. Using cryotherapy for an extended period of time, on the other hand, can be harmful to the healing process. If blood flow is decreased too much, damage can worsen, and continuous ice treatment raises the risk of skin burns and nerve damage.

The optimal dosage for cryotherapy in acute injury is unknown, although systematic evaluations suggest that ten-minute ice treatments followed by ten-minute periods without ice are the most effective. There is nothing like a one-size-fits-all dosage for all body parts, so as a clinician, it is important to make the best judgment and think about the specifics of each case.

When employing cryotherapy in those who are hypersensitive to cold, such as those with Raynaud's syndrome, diabetes, cold urticaria, paroxysmal cold hemoglobinuria, and patients with circulatory insufficiency, proceed with caution. To reduce the possibility of superficial nerve or skin damage, the ice should be wrapped in a wet towel or cloth. It is suggested that you read more about cryotherapy.

4) Compression:

Compression helps to prevent additional Oedema or swelling caused by the inflammatory process, as well as bleeding at the site of tissue damage. To produce a pleasant compression force without producing pain or narrowing blood vessels to the point of occlusion, an elasticated bandage should be utilized. Bandaging should start distally to the injury and progress proximally, with each layer overlapping the preceding one half. Although this is not the primary aim, it might potentially give minimal protection to the damaged body part from excessive movement.

5) Elevation:

Elevation reduces edema and facilitates the evacuation of waste from the injury site by boosting venous return to the systemic circulation and lowering hydrostatic pressure. Ascertain that the lower limb is elevated above the pelvis.

What Is Biceps Tendinopathy?

Biceps tendinopathy is a common injury that affects the biceps. Lifting, bending the elbow, and reaching up over the head requires the usage of the biceps muscle, which is situated in the front part of the upper arm. The biceps muscle joins to the front of the shoulder in two places and to a bone in the forearm in the lower half. Biceps tendinopathy, or tears of the upper biceps tendon, can be caused by lifting, tugging, reaching, or throwing repeatedly.

What Are the Symptoms of Biceps Tendinopathy?

Biceps tendinopathy causes pain in the front of the shoulder, which usually gets worse at night. Lifting, pulling, or repetitive overhead reaching may cause pain. Symptoms of tendinopathy normally appear gradually over time, though they can appear suddenly in persons with tendinitis or biceps rupture.

When a proximal biceps tendon ruptures, the person will experience sharp pain, a popping sensation, bruising, and edema. A lump in the lower biceps muscle could be felt or visible. After a shoulder rupture, shoulder pain may be entirely relieved. Surprisingly, a ruptured proximal biceps tendon only results in a 25% reduction in muscle strength.

How Is Biceps Tendinopathy Diagnosed?

The diagnosis of biceps tendinopathy is usually made based on the patient's medical history and a physical examination. The doctor measures the person's pain while moving the afflicted arm through a series of movements during the physical examination. X-rays are rarely useful in verifying biceps tendinopathy or rupture, although they may be indicated to help examine circumstances that contributed to the condition or rule out other issues.

An ultrasonography examination can assist confirm a biceps tendon damage diagnosis. Although MRI (magnetic resonance imaging) can offer detailed images of the biceps tendon, it is costly and rarely used.

What Is the Treatment for Biceps Tendinopathy?

Biceps tendinitis is treated by minimizing inflammation and swelling, strengthening the tendon, and avoiding tendon rupture. In most cases, surgery is not required.

Biceps tendinitis is frequently treated with a nonsteroidal anti-inflammatory medicine (NSAID) such as ibuprofen or naproxen for the first five to seven days. Lifting and reaching should be avoided until your symptoms improve. The following strategies are the safest to use:

  • Keep the arm tight to the body and down in front of it.

  • Lift objects that are near to your body.

  • Lift only light weights below the level of your shoulders.

  • When swimming, use sidestroke or breaststroke.

  • Toss balls sidearm or underhand.

  • In tennis, do not overhand serve.

  • Shoveling and other quick, ballistic movements should be avoided.

  • For pain, an NSAID gel or patch may be prescribed. These are used to apply on the skin.

  • To relieve discomfort and swelling, apply ice for 15 to 20 minutes every hour.

Physical Therapy: A course of physical therapy may be prescribed if symptoms do not improve. Stretching and strengthening exercises are generally included, as well as massage and ultrasound treatments. The exercises are designed to keep muscles, joints, and tendons flexible and mobile.

Injection: If the symptoms are severe or do not improve after trying the preceding treatments, the clinician may suggest injecting a steroid into the afflicted area to relieve inflammation and pain. Ultrasound-guided steroid injections are harmless ways of imagining the body's deep tissues. The primary principle of ultrasound-guided injection is that they allow the doctor to accurately direct the injection to the target tissues of the body. Ultrasound-guided steroid injections reduce the body's overall exposure to steroids and minimize the dose needed to treat the patient's symptoms. Following the injection, patients are usually advised to relax, ice, take Acetaminophen for pain, and do stretching and strengthening exercises.

Other Non-surgical Treatments: Although more investigation into these treatments is needed, regenerative injectable therapy with platelet-rich plasma or other biologic medicines may be considered. Other treatment options include laser therapy, iontophoresis, and dry needling, though more study is needed on these therapies.

Surgery: Surgery for biceps tendonitis or rupture is rarely necessary. However, it may be considered if a person is young and active, has considerable pain despite trying the previous treatments, or if there is aesthetic and cosmetic concern about the appearance of a lump in the biceps.


It is safe to gradually return to normal activities or sports after a biceps injury if treatment is completed and you are comfortable moving your arms in all directions without pain. Reduce activities that demand repetitive lifting and overhead activity if symptoms reoccur, and visit your physiotherapist for further guidance.

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Dr. Muthu Laakshmi. G
Dr. Muthu Laakshmi. G


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