Shoulder Pain and the Biceps Tendon

The biceps muscle, famous for creating the prominent curve of the upper arm when flexed, also plays an important but underappreciated role at the shoulder. The long head of the biceps tendon attaches to the superior glenoid labrum inside the shoulder joint, passes through the bicipital groove of the humerus, and is frequently involved in shoulder pain syndromes — either as a primary source of pain or as a secondary casualty of other shoulder pathology.

Bicipital Tendinitis

Inflammation of the long head of the biceps tendon produces pain at the front of the shoulder, often aggravated by overhead reaching, lifting, or rotating the forearm. It is common in overhead athletes, workers who perform repetitive lifting, and patients who have pre-existing rotator cuff pathology (because a dysfunctional rotator cuff shifts load onto the biceps tendon as a compensatory stabilizer).

SLAP Tears

The labrum where the biceps tendon attaches (the superior labrum anterior to posterior, or SLAP region) can be torn in overhead athletes, following shoulder dislocations, or with the cumulative stress of repetitive overhead activity. SLAP tears produce clicking, catching, and pain deep in the shoulder, often with a feeling of instability.

Conservative Treatment Options

Chiropractic management of bicipital tendinitis includes:

• Soft-tissue therapy directly to the bicipital groove to reduce tendon inflammation and adhesions
• Glenohumeral joint mobilization to restore proper mechanics and reduce abnormal load on the biceps tendon
• Cervical and thoracic adjustments to address any referred pain component
• Rotator cuff strengthening to restore proper humeral head centering and reduce compensatory biceps loading

If you have persistent front-of-shoulder pain, especially with lifting or overhead activities, our doctors at Total Health Family Clinic can assess whether the biceps tendon is involved and develop an appropriate treatment plan.