Long Head of Biceps Tendinitis: Causes, Symptoms, treatment & Physiotherapy in Cheshire

October 1, 2025

Shoulder pain is one of the most common musculoskeletal complaints we see at Weaver Physiotherapy & Sports Injury Clinic in Northwich, Cheshire. Among the many conditions that can affect the shoulder, Long Head of Biceps Tendinitis (LHBT) is a frequent source of pain, stiffness, and reduced function – especially in athletes and active individuals.


If you’ve noticed pain at the front of your shoulder that worsens with lifting, reaching, or overhead activity, you may be experiencing inflammation of the biceps tendon. The good news is, with early diagnosis and expert physiotherapy management, this condition can be successfully treated – allowing you to get back to sport, training, and everyday life without pain.


In this blog, we’ll explain:

    •    What the long head of the biceps tendon is

    •    The main causes and risk factors for tendinitis

    •    Common symptoms and warning signs

    •    How it is diagnosed

    •    Treatment and rehabilitation options at Weaver Physio

    •    Tips to prevent recurrence and protect your shoulder


Understanding the Long Head of the Biceps Tendon


The biceps muscle has two tendons at the shoulder:

    •    Short head – attaches to the coracoid process at the front of the shoulder blade.

    •    Long head – runs through the shoulder joint itself, attaching to the top of the glenoid (shoulder socket).


Because the long head of the biceps tendon passes through a narrow groove and is closely associated with the rotator cuff, it is more vulnerable to irritation, inflammation, and injury.


Its function is to:

    •    Assist in shoulder flexion (lifting the arm forward).

    •    Contribute to shoulder stability, particularly with overhead movements.

    •    Aid in supination (turning the palm upwards).


When overloaded or irritated, the tendon can become inflamed, leading to tendinitis. If not treated properly, this may progress to tendon degeneration (tendinopathy) or even partial tears.


Causes of Long Head of Biceps Tendinitis


At Weaver Physio, we often see long head of biceps tendinitis linked to repetitive overuse, poor biomechanics, or secondary shoulder problems.


1. Overuse & Repetitive Movements

    •    Repeated overhead activity (e.g. swimming, tennis, cricket, weightlifting).

    •    Heavy lifting in the gym without correct technique.

    •    Throwing sports that stress the tendon.


2. Shoulder Impingement & Rotator Cuff Dysfunction


The biceps tendon often works in partnership with the rotator cuff. Weakness, imbalance, or injury in the cuff can increase strain on the tendon.


3. Poor Posture


Rounded shoulders and forward head posture (common in office workers) can narrow the bicipital groove, irritating the tendon.


4. Age-Related Degeneration


As we age, tendons naturally lose some elasticity and become more prone to inflammation or microtears.


5. Direct Trauma


A fall, awkward lifting, or sudden jerk to the arm may trigger tendinitis.


Symptoms of Long Head of Biceps Tendinitis


The hallmark symptom is pain at the front of the shoulder, but several features can help identify LHBT tendinitis:

    •    Sharp or aching pain at the anterior shoulder.

    •    Pain aggravated by lifting, carrying, or overhead reaching.

    •    Tenderness when pressing on the bicipital groove (front of the shoulder).

    •    Discomfort when turning the palm upward against resistance (supination).

    •    Possible clicking or catching sensation in the shoulder.

    •    Weakness when lifting objects or performing overhead movements.


In severe or chronic cases, swelling and reduced range of motion may also be present.


Diagnosing Biceps Tendinitis


At Weaver Physiotherapy & Sports Injury Clinic, our expert clinicians use a combination of:

    •    Clinical history & symptom analysis – understanding your activity, pain pattern, and injury history.

    •    Physical examination – testing shoulder movement, strength, and palpating the tendon.

    •    Special tests – such as Speed’s test or Yergason’s test to reproduce symptoms.

    •    Referral for imaging (if required) – ultrasound or MRI may be suggested to rule out rotator cuff tears, labral pathology, or joint issues.


Accurate diagnosis is essential, as anterior shoulder pain may also be caused by conditions like rotator cuff tendinopathy, impingement syndrome, labral tears, or osteoarthritis.


Treatment for Long Head of Biceps Tendinitis


At Weaver Physio, we provide individualised, evidence-based treatment plans designed to:

    1.    Reduce pain and inflammation.

    2.    Restore shoulder movement and strength.

    3.    Correct underlying biomechanical issues.

    4.    Prevent recurrence and future injury.


1. Early Stage: Pain Relief & Inflammation Control

    •    Rest & activity modification – avoiding aggravating movements.

    •    Ice therapy – reduces acute inflammation.

    •    Manual therapy – soft tissue release, joint mobilisation.

    •    Taping techniques – to offload the tendon.


2. Physiotherapy & Rehabilitation

    •    Targeted strengthening – rotator cuff, scapular stabilisers, and core muscles.

    •    Stretching & mobility exercises – to restore range and reduce stiffness.

    •    Postural correction – improving alignment to reduce tendon stress.

    •    Progressive loading – gradually strengthening the tendon to handle daily and sporting demands.


3. Adjunct Treatments

    •    Shockwave Therapy – highly effective for chronic or stubborn tendon pain, stimulating healing.

    •    Acupuncture / Dry Needling – reduces pain and improves circulation.

    •    Sports & Deep Tissue Massage – eases tightness and improves blood flow.


4. Return to Sport & Prevention

    •    Video Gait & Movement Analysis – identifies biomechanical flaws.

    •    Strength & Conditioning Programmes – tailored to sport demands.

    •    Education & Training Advice – ensuring safe progression back to activity.


Recovery Timeline


Recovery depends on severity and treatment compliance, but typical timelines are:

    •    Mild tendinitis – 3 to 6 weeks with physiotherapy.

    •    Moderate cases – 6 to 12 weeks with progressive loading.

    •    Chronic / degenerative tendinopathy – 3 to 6 months, sometimes longer if associated with rotator cuff tears.


At Weaver Physio, our aim is not just pain relief but long-term recovery, ensuring you return to sport stronger and more resilient.


Preventing Biceps Tendinitis


Prevention is always better than cure. Our physiotherapists recommend:

    •    Warm up properly before sport or gym sessions.

    •    Strengthen rotator cuff and scapular stabilisers.

    •    Avoid excessive repetitive overhead movements.

    •    Correct poor posture, especially if working at a desk.

    •    Progress training gradually – avoid sudden load spikes.

    •    Include mobility and stretching in your routine.


Why Choose Weaver Physio for Shoulder & Sports Injuries?


At Weaver Physiotherapy & Sports Injury Clinic in Northwich, we pride ourselves on being Cheshire’s Sports Injury Specialists.

    •    🏆 70+ years of combined clinical experience

    •    🩺 Chartered Physiotherapists with advanced expertise in sports injuries

    •    💪 Evidence-based treatment plans tailored to your body and goals

    •    🌀 Specialist services including Shockwave Therapy, Sports Massage, Acupuncture, and Gait Analysis

    •    📍 Conveniently located in Northwich, supporting patients from Knutsford, Winsford, Middlewich, Frodsham, Tarporley, and across Cheshire


We help athletes, gym-goers, office workers, and active individuals recover faster, prevent setbacks, and stay pain-free.


Book Your Appointment Today


If shoulder pain is holding you back, don’t wait for it to get worse. Early treatment is the key to faster recovery and avoiding long-term damage.


👉 Call 01606 227484 to book your appointment.

👉 Visit www.weaverphysio.com to learn more.


At Weaver Physio, we are your trusted partner in recovery, performance, and pain-free living.



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Knee pain is one of the most common musculoskeletal complaints we see at Weaver Physiotherapy & Sports Injury Clinic in Northwich, Cheshire. From runners and athletes to office workers and retirees, knee problems can affect anyone. While many people are familiar with conditions such as arthritis, meniscus tears, or ligament injuries, one often-overlooked cause of knee swelling and discomfort is a Baker’s Cyst. Also known as a popliteal cyst, this condition can cause swelling behind the knee, stiffness, and reduced mobility – and if untreated, it may lead to ongoing pain or limit your ability to exercise, walk comfortably, or perform daily activities. In this in-depth guide, we’ll explain what a Baker’s Cyst is, the symptoms to look out for, why it develops, and most importantly – how physiotherapy can help you manage, treat, and prevent it. What is a Baker’s Cyst? A Baker’s Cyst is a fluid-filled swelling that develops behind the knee, in the popliteal space. It occurs when excess joint fluid (synovial fluid) escapes from the knee joint and collects in a small sac behind the knee. This fluid build-up is often a result of an underlying knee problem, such as: • Osteoarthritis (wear and tear of the knee joint) • Rheumatoid arthritis • Meniscus injuries (cartilage tears) • Ligament injuries • Knee joint inflammation The cyst itself is not dangerous, but it can be painful, restrict movement, and cause the back of the knee to feel tight – especially when bending or straightening the leg. Symptoms of a Baker’s Cyst Some people with a Baker’s Cyst may not experience symptoms at all, especially if the cyst is small. However, when symptoms do occur, they may include: ✔️ A noticeable lump or swelling behind the knee ✔️ Tightness or stiffness in the back of the knee ✔️ Pain or aching, particularly when straightening or bending the leg ✔️ Reduced flexibility and mobility ✔️ Swelling in the calf (if the cyst bursts and fluid leaks down the leg) In rare cases, a ruptured Baker’s Cyst can mimic the symptoms of a blood clot (deep vein thrombosis – DVT), with sudden calf swelling, pain, and redness. If you experience these symptoms, urgent medical assessment is required. Causes: Why Do Baker’s Cysts Develop? A Baker’s Cyst does not develop in isolation – it usually results from knee joint changes or injury that causes excess fluid production. Common causes include: 1. Arthritis • Osteoarthritis is a major cause. As the cartilage wears down, the joint becomes inflamed, leading to fluid build-up. • Rheumatoid arthritis, an autoimmune condition, can also trigger joint swelling and cyst formation. 2. Sports Injuries • Damage to the meniscus (cartilage) can irritate the joint and lead to cysts. • Ligament injuries (ACL, MCL) may also increase fluid build-up. 3. Overuse or Repetitive Strain • Runners, cyclists, and people who frequently squat or kneel may place repetitive stress on the knee joint, contributing to cyst formation. 4. Underlying Inflammation • Any condition that causes inflammation within the knee joint (including gout) can lead to synovial fluid leakage and cyst development. Diagnosis of a Baker’s Cyst At Weaver Physiotherapy & Sports Injury Clinic, our Chartered Physiotherapists carry out a detailed assessment to identify whether your knee pain and swelling are caused by a Baker’s Cyst, or another condition. The process may include: 🔹 Clinical assessment – checking your symptoms, medical history, and examining the back of the knee for swelling. 🔹 Ultrasound scan – often recommended to confirm the diagnosis. 🔹 MRI scan – if an underlying injury such as a cartilage tear is suspected. Early diagnosis is key. Many patients believe they just have “knee swelling” without realising it’s linked to an underlying joint issue. How Physiotherapy Helps Baker’s Cyst Physiotherapy is one of the most effective ways to manage and treat a Baker’s Cyst. While draining the cyst or surgery is sometimes required in severe cases, the majority of patients benefit from conservative treatment that targets the root cause. At Weaver Physio, our approach focuses on: 1. Pain Relief & Swelling Reduction • Manual therapy to ease stiffness • Ice, compression, and elevation strategies • Advice on activity modification to avoid aggravation 2. Improving Knee Mobility • Gentle stretching exercises to restore range of movement • Targeted flexibility work for the hamstrings and calf muscles 3. Strengthening Exercises • Quadriceps strengthening to improve joint support • Glute activation to reduce stress on the knee • Core stability to enhance overall lower-limb mechanics 4. Correcting Biomechanics • Video Gait Analysis and biomechanical assessment (part of our Runner’s MOT service) • Identifying imbalances in walking or running that may contribute to knee overload 5. Treating the Underlying Cause • If arthritis is the cause, we’ll develop a long-term joint management plan • If it’s due to a sports injury, we’ll provide a tailored rehabilitation programme Home Management Strategies Alongside professional physiotherapy, patients can often manage symptoms at home with: ✔️ Rest & Activity Modification – avoiding deep squats or repetitive knee strain ✔️ Ice Therapy – applying ice packs to reduce swelling ✔️ Compression Supports – knee braces can help control fluid build-up ✔️ Gentle Exercises – as advised by your physiotherapist When is Surgery Needed? Surgery is rarely the first option for Baker’s Cyst. It is usually only considered if: • The cyst is very large and painful • Conservative treatments have failed • The underlying cause (such as a meniscus tear) requires surgical repair In such cases, a surgeon may drain the cyst (aspiration) or repair the damaged structures inside the knee. Can a Baker’s Cyst Burst? Yes. In some cases, the cyst can rupture, releasing fluid into the calf. This can cause sudden pain, swelling, and bruising in the lower leg. It may resemble a DVT (blood clot), so it’s important to seek urgent medical advice to rule this out. Recovery Timeline Recovery depends on the underlying cause: • Minor cases: Symptoms may improve in a few weeks with rest and physiotherapy. • Arthritis-related cases: Long-term management is required, but physiotherapy helps control pain and mobility. • Sports injuries: Recovery may take 6–12 weeks, depending on the severity of the meniscus or ligament damage. At Weaver Physio, we’ll give you a personalised recovery plan so you know exactly what to expect at each stage. Preventing Baker’s Cyst While not all cases can be prevented, you can reduce your risk by: 🔹 Maintaining strong quadriceps, hamstrings, and glutes 🔹 Avoiding repetitive high-impact activities without proper recovery 🔹 Wearing appropriate footwear for your activity 🔹 Seeking physiotherapy early if you experience knee swelling or stiffness Why Choose Weaver Physio for Knee Pain? At Weaver Physiotherapy & Sports Injury Clinic in Northwich, Cheshire, we are specialists in diagnosing and treating knee injuries and conditions such as Baker’s Cyst. Here’s why patients across Cheshire – including Northwich, Knutsford, Winsford, Middlewich, Tarporley, and Frodsham – choose us: ✔️ 70+ years of combined clinical experience ✔️ Experts in sports injuries, arthritis, and musculoskeletal pain ✔️ Access to advanced services such as Shockwave Therapy, Acupuncture & Video Gait Analysis ✔️ Tailored rehabilitation plans that get to the root cause of your pain ✔️ Trusted by runners, athletes, and the local community Our goal is simple: to help you recover faster, prevent future injuries, and get back to living pain-free. Book Your Appointment If you’re struggling with knee pain or suspect you may have a Baker’s Cyst, don’t ignore the symptoms. Early treatment can make a huge difference in your recovery and long-term knee health. 📞 Call us today on 01606 227484 🌐 Visit us at http://www.weaverphysio.com Weaver Physiotherapy & Sports Injury Clinic – Your Trusted Partner in Recovery, Performance & Pain-Free Living.
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