Long head of the biceps tendon pain: differential diagnosis and treatment

Ryan J. Krupp, Mark A. Kevern, Michael D. Gaines, Stanley Kotara, Steven B. Singleton

Research output: Contribution to journalReview articlepeer-review

49 Scopus citations


Though the role of the long head of the biceps tendon (LHBT) in shoulder pathology has been extensively investigated, it remains controversial. Historically, there have been large shifts in opinions on LHBT function, ranging from being a vestigial structure to playing a critical role in shoulder stability. Today, despite incomplete understanding of its clinical or biomechanical involvement, most investigators would agree that LHBT pathology can be a significant cause of anterior shoulder pain. When the biceps tendon is determined to be a significant contributor to a patient's symptoms, the treatment options include various conservative interventions and possible surgical procedures, such as tenotomy, transfer, or tenodesis. The ultimate treatment decision is based upon a variety of factors, including the patient's overall medical condition, severity, and duration of symptoms, expectations, associated shoulder pathology, and surgeon preference. The purpose of this manuscript is to review current anatomic, functional, and clinical information regarding the LHBT, including conservative treatment, surgical treatment, and postsurgical rehabilitation regimens.

Original languageEnglish (US)
Pages (from-to)55-70
Number of pages16
JournalJournal of Orthopaedic and Sports Physical Therapy
Issue number2
StatePublished - Feb 2009
Externally publishedYes


  • Impingement
  • Rotator cuff
  • Shoulder
  • Tendinitis
  • Tendinosis

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation


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