Biceps Tendinopathy: Physiotherapy Assessment & Rehabilitation
Biceps tendinopathy is a common source of anterior shoulder pain and often occurs alongside other shoulder conditions such as rotator cuff–related pain or labral injuries. It can develop gradually with repetitive use or follow a sudden increase in load or overhead activity.
At Fit2Function Allied Health, we provide evidence-based physiotherapy for biceps tendinopathy, focusing on reducing pain, restoring shoulder capacity, and addressing contributing factors to support long-term recovery.
What is biceps tendinopathy?
Biceps tendinopathy typically involves the long head of the biceps tendon, which runs from the biceps muscle in the upper arm into the shoulder joint and attaches near the labrum.
The tendon plays a role in:
-
Shoulder stability
-
Lifting and carrying tasks
-
Overhead and throwing movements
Biceps tendinopathy is now understood as a load-related tendon condition, where the tendon’s capacity is temporarily exceeded by activity demands rather than an isolated inflammatory process.
Common causes
Biceps tendinopathy may develop due to:
-
Repetitive or sustained overhead activity
-
Sudden increases in training or workload
-
Poor shoulder load tolerance or strength deficits
-
Coexisting rotator cuff or labral pathology
-
Altered shoulder or scapular movement patterns
Common symptoms
Symptoms may include:
-
Pain at the front of the shoulder or upper arm
-
Pain with lifting, pulling, or carrying
-
Discomfort with overhead activity
-
Local tenderness along the biceps tendon
-
Reduced confidence using the arm under load
Pain may be activity-related and fluctuate depending on load.
Physiotherapy assessment
Accurate assessment is important, as biceps tendon pain often coexists with other shoulder conditions.
Our physiotherapists assess:
-
Shoulder and elbow range of motion
-
Biceps, rotator cuff, and scapular strength
-
Symptom response to loading
-
Work, sport, and daily activity demands
Assessment findings guide individualised rehabilitation planning.
Do I need imaging?
Imaging is not routinely required for biceps tendinopathy.
Ultrasound or MRI may be considered if:
-
Symptoms fail to improve with rehabilitation
-
There is suspicion of tendon rupture
-
Significant trauma has occurred
-
Surgical decision-making is being considered
As with other shoulder conditions, imaging findings are interpreted in the context of symptoms and function.
Physiotherapy rehabilitation for biceps tendinopathy
Rehabilitation focuses on improving tendon load tolerance and shoulder function.
Key components include:
-
Gradual, progressive loading of the biceps tendon
-
Rotator cuff and scapular strengthening
-
Load management and activity modification
-
Education to support confidence and self-management
Exercises are progressed based on symptom response and functional capacity, not pain avoidance alone.
Is surgery required?
Surgery is rarely required for isolated biceps tendinopathy. Most people recover well with structured, progressive rehabilitation.
Surgical options may be considered in complex cases or when significant coexisting shoulder pathology is present.
Return to work, sport, and lifting
Safe return to higher-level activity requires:
-
Adequate biceps and shoulder strength
-
Tolerance to lifting and pulling tasks
-
Control during overhead or loaded positions
-
Confidence using the arm without fear of damage
Our physiotherapists guide graded return to work and sport using progressive loading strategies.
How our physiotherapists help
At Fit2Function Allied Health, we:
-
Use contemporary tendon management principles
-
Address contributing shoulder and upper limb factors
-
Individualise rehabilitation programs
-
Focus on long-term shoulder capacity and resilience
Book a shoulder assessment
If you are experiencing persistent front-of-shoulder pain or have been diagnosed with biceps tendinopathy, our physiotherapists can assess your shoulder and guide effective rehabilitation.
Learn more about shoulder injuries & physiotherapy
Explore our other shoulder condition pages to understand evidence-based assessment, rehabilitation, and return-to-activity strategies:
Rotator Cuff Injuries | Subacromial Pain / Shoulder Impingement | Frozen Shoulder | Shoulder Instability & Dislocation | AC Joint Injuries | Labral Injuries (SLAP, Bankart & Hill-Sachs) | Biceps Tendon Pain / Anterior shoulder pain
Our physiotherapists provide individualised programs focused on restoring movement, strength, and long-term shoulder health.
