Biceps Tendinopathy: What Fitness Enthusiasts Should Know
- Tim Stevenson
- Jul 3
- 3 min read
If you’ve ever felt a dull, nagging pain at the front of your shoulder - especially during pressing, pulling, or overhead movements - you might be dealing with something called biceps tendinopathy, specifically involving the long head of the biceps tendon (LHBT)
Let’s break it down in a way that makes sense without needing a medical degree.
What Is Biceps Tendinopathy?
Biceps tendinopathy refers to damage or irritation of the long head of the biceps tendon, which runs from your upper arm into the front of your shoulder. This condition often causes pain in the front of the shoulder, especially during lifting, reaching, or resistance exercises.
It’s not just a simple injury - it’s more like a spectrum of issues that can range from mild irritation to significant tendon damage or even tears.
How Does It Happen?
Your tendons are built to handle load - they transfer force from muscle to bone. But they also need time to recover. When you apply too much load (e.g. heavy lifting, repetitive motion) or not enough rest, your tendon can get overstressed.
Over time, this leads to a breakdown in the tendon’s natural repair cycle. That’s when things start to go wrong.
Two big factors in tendon injuries are:
How much load you’re putting on the tendon (volume, intensity, repetition)
How your body responds to that load (inflammation, healing, or breakdown)
The Body’s Response: A Balancing Act
In a healthy scenario, loading a tendon triggers a small, helpful inflammatory response. This helps your body repair and strengthen the tendon by rebuilding collagen - the main protein in tendons.
But if the load exceeds what your tendon can handle, it leads to too much collagen breakdown, not enough repair, and the tendon becomes weaker. Think of it like doing more reps than your body can recover from, every day, for weeks. Eventually, something gives.
When this happens repeatedly without enough rest, your body kicks off a dysregulated inflammatory response, which leads to degenerative changes in the tendon. That’s what we call tendinopathy.
Why It’s Tricky to Diagnose
Biceps tendinopathy doesn’t always show up on its own. In fact, studies show that 91% of people with this issue also have rotator cuff injuries. So, it’s hard to say whether the pain is purely from the biceps tendon or a mix of other problems.
There’s also some debate in the research world about the exact role of the biceps tendon in shoulder movement and stability which makes understanding and treating it even more complex.
How to Keep Your Tendons Healthy
If you’re into gym training or sports, here are some take-home tips to reduce your risk of tendinopathy:
Respect your load: Avoid big spikes in training volume or intensity.
Consider your recovery: Tendons need time off too, they are actually slower to recover than muscle due to a generally lower blood supply. Extended periods of high volume or intense training need to be met with appropriate recovery strategies.
Strengthen smart: Eccentric and isometric exercises (like slow lowers or holds) can help restore tendon health.
Listen to what your body is telling you: Pain can be a warning sign, listen to it.
Get assessed: If pain persists, see a rehabilitation professional to check for rotator cuff involvement or other joint issues.
Final Thoughts
Understanding how tendons respond to load, and giving your body the time and tools to recover properly can keep you training pain-free. The game is to train smart.
Remember: it's not about how much training you can do but how much you can recover from.
REGAIN CONTROL, REDUCE PAIN AND LAY THE FOUNDATION FOR STRENGTH
Our 6-week RESTORE shoulder rehab training programme focuses on reducing pain and restoring your ability to move without fear. If your shoulder feels painful, weak or unpredictable, especially in everyday tasks or basic lifts, this programme is for you.
Comentarios