Bicep tendonitis is an irritation and inflammation of the tendons connecting the biceps muscle to the shoulder or elbow. It often results from repetitive overhead motion or overuse, such as from weightlifting or sports. This condition causes pain and tenderness, typically in the front of the shoulder, which worsens with physical activity. You can work out, but it requires smart modification of your routine and listening closely to your body’s signals. The focus must shift entirely from building muscle or strength to promoting healing and maintaining overall fitness.
The Golden Rule of Pain and Activity Modification
The primary principle for managing any tendon issue while exercising is the “no pain” rule. You must immediately stop any movement that causes sharp, burning, or aching pain in the affected tendon. This type of discomfort signals that the activity is causing further irritation or micro-trauma to the already compromised tissue.
It is important to distinguish between the deep, throbbing ache of tendon pain and the general fatigue or soreness associated with muscle work. Pushing through tendon pain will only delay recovery and can lead to more severe issues, such as a tendon tear. For acute flare-ups, initial self-care involves the R.I.C.E. protocol: Rest, Ice, Compression, and Elevation.
Complete rest is generally not recommended for long periods, as it can lead to stiffness and muscle weakness. Instead, apply “relative rest” by modifying your activity level to accommodate the injury without stopping movement entirely. This maintains flexibility and circulation while giving the tendon time to heal.
High-Risk Exercises to Avoid
Certain movements place maximum mechanical stress on the biceps tendon and must be avoided or heavily modified during recovery. Overhead movements are particularly problematic because they can cause the tendon to be compressed or pinched at the shoulder joint. Exercises like overhead shoulder presses, full-range pull-ups, and chin-ups should be temporarily eliminated from your routine.
Heavy lifting of any kind is also contraindicated, as maximal effort overloads the compromised tendon, increasing the risk of further damage. Even if the exercise is not directly for the biceps, using heavy weight in compound movements can place undue strain on the tendon. The goal is to reduce the overall load the tendon must bear.
Specific to arm training, avoid full-range biceps curls, especially the fully extended position at the bottom of the movement. This end-range extension puts the greatest strain on the tendon. Limit the movement to a mid-range motion, avoiding the point of full stretch. High-repetition, low-weight training can also be detrimental, as the constant, repetitive motion irritates the tendon sheath.
Safe Workouts for Recovery and Maintenance
The focus of your workout should shift to gentle, pain-free movements that promote healing and maintain overall fitness. Light strengthening and mobility exercises are beneficial for recovery, as they help improve muscle balance and reduce strain on the tendon. Examples include very light, mid-range biceps curls, where you use minimal weight and stop before the point of pain.
You can also incorporate gentle shoulder mobility work, such as shoulder blade squeezes and controlled internal or external rotation exercises, often using a light resistance band or no weight at all. These movements help stabilize the shoulder joint, which reduces the workload on the biceps tendon. The intensity of these exercises should be low, focusing on controlled movement rather than muscle fatigue.
To maintain cardiovascular health and overall strength, prioritize non-arm intensive workouts. Lower body training, such as squats, lunges, and leg presses, can be performed without stressing the upper body. Cardio options like stationary cycling or using an elliptical machine without engaging the arm handles are excellent ways to stay active.
Technique is paramount; movements should be slow and controlled to prevent sudden jerking motions that aggravate the tendon. Modification strategies, such as using a neutral grip (palms facing each other) instead of a supinated grip (palms up) for pulling movements, can reduce strain. Using resistance bands or cable machines instead of heavy free weights provides a more consistent and controlled resistance profile.
When to Seek Professional Guidance
While self-management is often effective, there are clear indicators that professional help is necessary. If your pain persists for more than a few weeks despite consistent rest and activity modification, consult a healthcare provider. Pain that worsens, or pain that begins to interfere with simple daily tasks, such as dressing or lifting a coffee cup, also warrants professional evaluation.
A medical professional can rule out a more severe injury, such as a partial or complete tendon tear, which may require more aggressive treatment. A physical therapist (PT) is particularly helpful, as they can provide a personalized, progressive strengthening program tailored to your specific injury. The PT will guide you through exercises that safely stimulate the tendon to rebuild its strength without causing further inflammation.