Table of ContentsView AllTable of ContentsAnatomyFunctionAssociated ConditionsTreatment
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Associated Conditions
Treatment
The biceps is one of four muscles alongside the brachialis, brachioradialis, and coracobrachialis muscles that make up the upper arm.
The termbicepsis both singular and plural. A single muscle is described as biceps, not bicep.
The biceps muscle is comprised of two heads. At each end are connective tissues calledtendonsthat anchor the muscles to bone.
The two heads join in the middle arm to form a combined muscle belly. Although the heads work in tandem to move the forearm, they are anatomically distinct, with no conjoined fibers.
As the heads extend downward toward the elbow, they rotate 90 degrees and attach to a rough projection just beneath the neck of the radius called the radial tuberosity.
Of the other three muscles that make up the upper arm, the biceps is the only one to cross two joints: the elbow joint and the glenohumeral (shoulder) joint.
Despite what some think, the biceps is not the most powerful flexor of the forearm. Although the biceps is the most prominent muscle of the upper arm, it serves to support and stabilize the deeper (and stronger) brachialis muscle whenever lifting or lowering the forearm.
As the biceps muscle contracts, it can do one of two things (or both together):
The biceps also weakly assists with arm movements at the glenohumeral joint, including forward flexion (lifting the entire arm forward), abduction (opening the arm to the side), and adduction (folding the arm across the body).
The small head of the biceps is important in stabilizing the scapula, allowing us to carry heavy weights when the arm is in an extended downward position.
raquel arocena torres / Getty Images
Nerve Supply
In addition to directing the contraction of muscles, the musculocutaneous nerve (also referred to as the fifth, sixth, and seventh cervical nerves) provides sensations to the outer side of the forearm from the elbow to the wrist.
A separate nerve, known as theradial nerve, services the brachioradialis muscle.
Because the biceps are involved in such vital tasks as lifting and gesturing, the tendons and tissues that make up the muscle are vulnerable to harm. Most occur as a result of physical trauma orrepetitive activity.
Among some of the more common conditions affecting the biceps:
While some conditions, like minor sprains orcontusions, can be diagnosed with a physical exam, others may require lab tests to detectinflammation in bloodor joint fluid and/or imaging tests like X-ray, ultrasound, ormagnetic resonance imaging (MRI)to check for rupture, bleeding, or other soft tissue injuries.
Nonsteroidal anti-inflammatory drugslike Advil or Motrin (ibuprofen) or Aleve or Naprosyn (naproxen) can help reduce pain and swelling.
Intra-articular cortisone injectionsmay also be used to temper pain and inflammation associated with chronic tendinitis. The most severe injuries may require surgery and postoperative physical therapy to regain strength and range of motion in the affected arm.
Corrective surgeries are typically reserved for elite athletes or people with severe ruptures or intractable pain in whom conservative treatments have failed.
Biceps Tenodesis
Among the approaches:
Recovery may take longer if more than one procedure is performed. One example is aSLAP repair surgeryused to fix the tendon encircling the glenoid where proximal bicep tendon is attached.
Biceps Tenotomy
Biceps tenotomy, also known as a tendon release, is an arthroscopic procedure in which the proximal tendon is severed and allow to hang down the upper arm. It is a fast and effective way to treat pain without compromising the integrity or stability of the shoulder.
Tenotomy is reserved for sedentary people who are less likely to notice any difference in arm strength or function after surgery.
Tenotomy is less reasonable for athletes who may experience a marked loss of strength or develop spasms when weightlifting or doing repetitive turning motions (like rowing). A Popeye deformity is also possible.
Recovery from a biceps tenotomy is usually faster than tenodesis, but involves more or less the same rehabilitation program.
Rehabilitation
A structured program of physical therapy and rehabilitation is considered essential following tenodesis or tenotomy. Without them, the odds of fully recovering biceps strength, mobility, andrange of motion (ROM)are low.
The program is generally broken into three stages:
Athletes and active adults may embark on an additional two weeks of advanced strength training to restore them to peak performance.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Biceps tendon injuries.American Academy of Orthopaedic Surgeons.Biceps tendon tear at the elbow.American Academy of Orthopaedic Surgeons.Biceps tendon tear at the shoulder.American Academy of Orthopaedic Surgeons.Biceps tendinitis.Dubrow SA, Streit JJ, Shishani Y, Robbin MR, Gobezie R.Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI.Open Access J Sports Med. 2014;5:81-7. doi:10.2147/OAJSM.S58225American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Nair R, Kahlenberg CA, Patel RM, Knesek M, Terry MA.All-arthroscopic suprapectoral biceps tenodesis.Arthrosc Tech. 2015;4(6):e855-61. doi:10.1016/j.eats.2015.08.010Amaravathi RS, Pankappilly B, Kany J.Arthroscopic keyhole proximal biceps tenodesis: a technical note.J Orthop Surg (Hong Kong). 2011;19(3):379-83. doi:10.1177/230949901101900326Lopez-vidriero E, Costic RS, Fu FH, Rodosky MW.Biomechanical evaluation of 2 arthroscopic biceps tenodeses: double-anchor versus percutaneous intra-articular transtendon (PITT) techniques.Am J Sports Med. 2010;38(1):146-52. doi:10.1177/0363546509343803Amouyel T, Le moulec YP, Tarissi N, Saffarini M, Courage O.Arthroscopic biceps tenodesis using interference screw fixation in the bicipital groove.Arthrosc Tech. 2017;6(5):e1953-e1957. doi:10.1016/j.eats.2017.07.025University of Wisconsin Sports Medicine. Rehabilitation guidelines for biceps tenodesis.American Academy of Orthopaedic Surgeons.SLAP tears.Ribeiro FR, Ursolino APS, Ramos VFL, Takesian FH, Tenor Júnior AC, Costa MPD.Disorders of the long head of the biceps: tenotomy versus tenodesis.Rev Bras Ortop. 2017;52(3):291-297. doi:10.1016/j.rboe.2017.04.001Friedman JL, Fitzpatrick JL, Rylander LS, Bennett C, Vidal AF, Mccarty EC.Biceps tenotomy versus tenodesis in active patients younger than 55 years: is there a difference in strength and outcomes?Orthop J Sports Med. 2015;3(2):2325967115570848. doi:10.1177/2325967115570848Additional ReadingKim Y, Jeong J, Lee H, et al.Arthroscopic Tenodesis of the Long Head of the Biceps Tendon.JBJS Essen Surg Tech.2017 Jun;7(3):e19. doi:10.2106/JBJS.ST.16.00089.Landin D, Thompson M, Jackson M.Actions of the Biceps Brachii at the Shoulder: A Review.J Clin Med Res.2017 Aug;9(8):667-70. doi:10.14740/jocmr2901w.Liechti D, Mitchell J, Menge T, et al.Immediate physical therapy without postoperative restrictions following open subpectoral biceps tenodesis: low failure rates and improved outcomes at a minimum 2-year follow-up.J Shoulder Elbow Surg. 2018:27(1):1891-7. doi:10.1016/jse.2018.02.016.McCrum C, Alluri R, Batech M, et al.Long Head of the Biceps Tenotomy and Tenodesis: Does Technique, Location, or Implant Influence Outcomes and Complications?Arthroscopy.2017 Jun;33(6):e11. doi:10.1016/j.arthro.2017.04.048.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Biceps tendon injuries.American Academy of Orthopaedic Surgeons.Biceps tendon tear at the elbow.American Academy of Orthopaedic Surgeons.Biceps tendon tear at the shoulder.American Academy of Orthopaedic Surgeons.Biceps tendinitis.Dubrow SA, Streit JJ, Shishani Y, Robbin MR, Gobezie R.Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI.Open Access J Sports Med. 2014;5:81-7. doi:10.2147/OAJSM.S58225American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Nair R, Kahlenberg CA, Patel RM, Knesek M, Terry MA.All-arthroscopic suprapectoral biceps tenodesis.Arthrosc Tech. 2015;4(6):e855-61. doi:10.1016/j.eats.2015.08.010Amaravathi RS, Pankappilly B, Kany J.Arthroscopic keyhole proximal biceps tenodesis: a technical note.J Orthop Surg (Hong Kong). 2011;19(3):379-83. doi:10.1177/230949901101900326Lopez-vidriero E, Costic RS, Fu FH, Rodosky MW.Biomechanical evaluation of 2 arthroscopic biceps tenodeses: double-anchor versus percutaneous intra-articular transtendon (PITT) techniques.Am J Sports Med. 2010;38(1):146-52. doi:10.1177/0363546509343803Amouyel T, Le moulec YP, Tarissi N, Saffarini M, Courage O.Arthroscopic biceps tenodesis using interference screw fixation in the bicipital groove.Arthrosc Tech. 2017;6(5):e1953-e1957. doi:10.1016/j.eats.2017.07.025University of Wisconsin Sports Medicine. Rehabilitation guidelines for biceps tenodesis.American Academy of Orthopaedic Surgeons.SLAP tears.Ribeiro FR, Ursolino APS, Ramos VFL, Takesian FH, Tenor Júnior AC, Costa MPD.Disorders of the long head of the biceps: tenotomy versus tenodesis.Rev Bras Ortop. 2017;52(3):291-297. doi:10.1016/j.rboe.2017.04.001Friedman JL, Fitzpatrick JL, Rylander LS, Bennett C, Vidal AF, Mccarty EC.Biceps tenotomy versus tenodesis in active patients younger than 55 years: is there a difference in strength and outcomes?Orthop J Sports Med. 2015;3(2):2325967115570848. doi:10.1177/2325967115570848Additional ReadingKim Y, Jeong J, Lee H, et al.Arthroscopic Tenodesis of the Long Head of the Biceps Tendon.JBJS Essen Surg Tech.2017 Jun;7(3):e19. doi:10.2106/JBJS.ST.16.00089.Landin D, Thompson M, Jackson M.Actions of the Biceps Brachii at the Shoulder: A Review.J Clin Med Res.2017 Aug;9(8):667-70. doi:10.14740/jocmr2901w.Liechti D, Mitchell J, Menge T, et al.Immediate physical therapy without postoperative restrictions following open subpectoral biceps tenodesis: low failure rates and improved outcomes at a minimum 2-year follow-up.J Shoulder Elbow Surg. 2018:27(1):1891-7. doi:10.1016/jse.2018.02.016.McCrum C, Alluri R, Batech M, et al.Long Head of the Biceps Tenotomy and Tenodesis: Does Technique, Location, or Implant Influence Outcomes and Complications?Arthroscopy.2017 Jun;33(6):e11. doi:10.1016/j.arthro.2017.04.048.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Biceps tendon injuries.American Academy of Orthopaedic Surgeons.Biceps tendon tear at the elbow.American Academy of Orthopaedic Surgeons.Biceps tendon tear at the shoulder.American Academy of Orthopaedic Surgeons.Biceps tendinitis.Dubrow SA, Streit JJ, Shishani Y, Robbin MR, Gobezie R.Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI.Open Access J Sports Med. 2014;5:81-7. doi:10.2147/OAJSM.S58225American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Nair R, Kahlenberg CA, Patel RM, Knesek M, Terry MA.All-arthroscopic suprapectoral biceps tenodesis.Arthrosc Tech. 2015;4(6):e855-61. doi:10.1016/j.eats.2015.08.010Amaravathi RS, Pankappilly B, Kany J.Arthroscopic keyhole proximal biceps tenodesis: a technical note.J Orthop Surg (Hong Kong). 2011;19(3):379-83. doi:10.1177/230949901101900326Lopez-vidriero E, Costic RS, Fu FH, Rodosky MW.Biomechanical evaluation of 2 arthroscopic biceps tenodeses: double-anchor versus percutaneous intra-articular transtendon (PITT) techniques.Am J Sports Med. 2010;38(1):146-52. doi:10.1177/0363546509343803Amouyel T, Le moulec YP, Tarissi N, Saffarini M, Courage O.Arthroscopic biceps tenodesis using interference screw fixation in the bicipital groove.Arthrosc Tech. 2017;6(5):e1953-e1957. doi:10.1016/j.eats.2017.07.025University of Wisconsin Sports Medicine. Rehabilitation guidelines for biceps tenodesis.American Academy of Orthopaedic Surgeons.SLAP tears.Ribeiro FR, Ursolino APS, Ramos VFL, Takesian FH, Tenor Júnior AC, Costa MPD.Disorders of the long head of the biceps: tenotomy versus tenodesis.Rev Bras Ortop. 2017;52(3):291-297. doi:10.1016/j.rboe.2017.04.001Friedman JL, Fitzpatrick JL, Rylander LS, Bennett C, Vidal AF, Mccarty EC.Biceps tenotomy versus tenodesis in active patients younger than 55 years: is there a difference in strength and outcomes?Orthop J Sports Med. 2015;3(2):2325967115570848. doi:10.1177/2325967115570848
Cleveland Clinic.Biceps tendon injuries.
American Academy of Orthopaedic Surgeons.Biceps tendon tear at the elbow.
American Academy of Orthopaedic Surgeons.Biceps tendon tear at the shoulder.
American Academy of Orthopaedic Surgeons.Biceps tendinitis.
Dubrow SA, Streit JJ, Shishani Y, Robbin MR, Gobezie R.Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI.Open Access J Sports Med. 2014;5:81-7. doi:10.2147/OAJSM.S58225
American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.
Nair R, Kahlenberg CA, Patel RM, Knesek M, Terry MA.All-arthroscopic suprapectoral biceps tenodesis.Arthrosc Tech. 2015;4(6):e855-61. doi:10.1016/j.eats.2015.08.010
Amaravathi RS, Pankappilly B, Kany J.Arthroscopic keyhole proximal biceps tenodesis: a technical note.J Orthop Surg (Hong Kong). 2011;19(3):379-83. doi:10.1177/230949901101900326
Lopez-vidriero E, Costic RS, Fu FH, Rodosky MW.Biomechanical evaluation of 2 arthroscopic biceps tenodeses: double-anchor versus percutaneous intra-articular transtendon (PITT) techniques.Am J Sports Med. 2010;38(1):146-52. doi:10.1177/0363546509343803
Amouyel T, Le moulec YP, Tarissi N, Saffarini M, Courage O.Arthroscopic biceps tenodesis using interference screw fixation in the bicipital groove.Arthrosc Tech. 2017;6(5):e1953-e1957. doi:10.1016/j.eats.2017.07.025
University of Wisconsin Sports Medicine. Rehabilitation guidelines for biceps tenodesis.
American Academy of Orthopaedic Surgeons.SLAP tears.
Ribeiro FR, Ursolino APS, Ramos VFL, Takesian FH, Tenor Júnior AC, Costa MPD.Disorders of the long head of the biceps: tenotomy versus tenodesis.Rev Bras Ortop. 2017;52(3):291-297. doi:10.1016/j.rboe.2017.04.001
Friedman JL, Fitzpatrick JL, Rylander LS, Bennett C, Vidal AF, Mccarty EC.Biceps tenotomy versus tenodesis in active patients younger than 55 years: is there a difference in strength and outcomes?Orthop J Sports Med. 2015;3(2):2325967115570848. doi:10.1177/2325967115570848
Kim Y, Jeong J, Lee H, et al.Arthroscopic Tenodesis of the Long Head of the Biceps Tendon.JBJS Essen Surg Tech.2017 Jun;7(3):e19. doi:10.2106/JBJS.ST.16.00089.Landin D, Thompson M, Jackson M.Actions of the Biceps Brachii at the Shoulder: A Review.J Clin Med Res.2017 Aug;9(8):667-70. doi:10.14740/jocmr2901w.Liechti D, Mitchell J, Menge T, et al.Immediate physical therapy without postoperative restrictions following open subpectoral biceps tenodesis: low failure rates and improved outcomes at a minimum 2-year follow-up.J Shoulder Elbow Surg. 2018:27(1):1891-7. doi:10.1016/jse.2018.02.016.McCrum C, Alluri R, Batech M, et al.Long Head of the Biceps Tenotomy and Tenodesis: Does Technique, Location, or Implant Influence Outcomes and Complications?Arthroscopy.2017 Jun;33(6):e11. doi:10.1016/j.arthro.2017.04.048.
Kim Y, Jeong J, Lee H, et al.Arthroscopic Tenodesis of the Long Head of the Biceps Tendon.JBJS Essen Surg Tech.2017 Jun;7(3):e19. doi:10.2106/JBJS.ST.16.00089.
Landin D, Thompson M, Jackson M.Actions of the Biceps Brachii at the Shoulder: A Review.J Clin Med Res.2017 Aug;9(8):667-70. doi:10.14740/jocmr2901w.
Liechti D, Mitchell J, Menge T, et al.Immediate physical therapy without postoperative restrictions following open subpectoral biceps tenodesis: low failure rates and improved outcomes at a minimum 2-year follow-up.J Shoulder Elbow Surg. 2018:27(1):1891-7. doi:10.1016/jse.2018.02.016.
McCrum C, Alluri R, Batech M, et al.Long Head of the Biceps Tenotomy and Tenodesis: Does Technique, Location, or Implant Influence Outcomes and Complications?Arthroscopy.2017 Jun;33(6):e11. doi:10.1016/j.arthro.2017.04.048.
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