Bicep Strain: Causes, Symptoms, and Exercises to Relieve Pain and Prevent Injury

Is your upper arm sore after a tough workout? Or does it hurt when you lift your toddler or a heavy bag of groceries? You may be experiencing bicep strain, which refers to irritation or injury of the bicep muscle or tendon.

While you probably don’t talk (or think) about your biceps aside from when you lift weights at the gym, the reality is that they are important for many everyday movements. You rely on them to help you lift and carry all sorts of things. Your biceps are fully capable of handling this responsibility, but occasionally, they can become strained from doing more than your body is prepared for. 

“Thankfully, your bicep muscles are strong and resilient, so even if you do strain them, they usually recover quickly,” says Katie Schaner, PT, DPT, a physical therapist at Hinge Health. 

Read on to learn more about bicep strain, common causes, and ways to treat and prevent one — especially with exercises recommended by Hinge Health physical therapists.

What Is a Bicep Strain?

Your bicep muscle is in the front of your upper arm and has two tendons that attach it to your shoulder blade. A bicep strain happens when the muscle fibers are stretched beyond their usual range, which can sometimes result in small tears, explains Dr. Schaner. “This usually occurs after some sort of a repetitive activity, or lifting something heavy that your body wasn’t quite ready for.” While hearing about a muscle tear can sound scary, bicep strain is a common injury and is typically mild. Your body is fully capable of repairing the muscle tissue over time. 

Bicep strains are categorized into three grades, says Dr. Schaner, depending on the severity:

• Grade 1. There’s some slight stretching and injury to muscle fibers, but no tear. “It’s more of a muscle pull, so you won’t lose full range of motion,” explains Dr. Schaner. You will, however, usually notice some mild swelling and pain.

• Grade 2. You’ll usually have a slight tear, and more damage to muscle fibers, leading to more pain, swelling, and loss of range of motion.

• Grade 3. This is a complete muscle tear that usually causes noticeable pain, swelling, weakness, and loss of function in your arm. This type of injury may require more time to heal and possibly surgery, but recovery is entirely possible with the right treatment plan.

Symptoms of Bicep Strain

The most common symptom of bicep strain is pain or tenderness right in the bicep location that worsens with activity. Other bicep strain symptoms include:

• Shoulder weakness

• Pain and difficulty lifting your arm above your head

• Bicep swelling or redness

• Pain that radiates down into your hand

• Difficulty moving or rotating your arm

If you have a grade 3 bicep strain, you may also notice bruising along with the swelling, as well as a “Popeye” bulge in your upper arm, says Dr. Schaner.

Bicep Strain Causes 

Bicep strain can happen to anyone. “They’re normal when you’re busy with everyday activities like carrying and lifting,” points out Dr. Schaner. But some things that can make bicep strains more likely include: 

• Repetitive activities. If your job involves repetitive lifting and moving, for example, you may be more vulnerable to a bicep strain, says Dr. Schaner. Certain sports that require repetitive overhead motion, like swimming, tennis, and baseball, can also strain your biceps.

• Normal aging. As we get older, our muscles and tendons weaken slightly. Regular strengthening exercises can help protect your biceps during everyday activities. 

• Injury. Falling on an outstretched arm or reaching out to catch a falling object can put pressure on your bicep that can lead to a strain.  

Smokers are also more likely to have increased risk of bicep strain, according to a 2020 study published in Therapeutic Advances in Chronic Disease. It’s probably due to poorer circulation, which means less oxygen and other healing nutrients get to your bicep muscle and tendon tissues.

The above bicep strain exercises and stretches are recommended by Hinge Health physical therapists. These moves not only strengthen your biceps, but the surrounding shoulder, arm, and back muscles as well, says Dr. Schaner. This allows you to build support around the biceps, so they don’t have to work as hard, and are less likely to develop strain and injury.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Bicep Strain Treatment Options 

With bicep strains, a bit of rest and avoiding activities that aggravate your bicep muscle can be helpful. But generally, movement is medicine, stresses Dr. Schaner. “Your biceps, like all the other muscles in your body, are designed to stay active,” she explains. “If you avoid movement, it reduces the flow of healing nutrients your biceps need to stay healthy.” 

Here’s what Hinge Health physical therapists recommend for bicep strain treatment. 

• Physical therapy. This is generally a first-line treatment for bicep strain, says Dr. Schaner. “It will help your bicep muscle heal, and your PT can show you strengthening and stretching exercises to help you regain strength, mobility, and flexibility in your arm,” she explains. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. 

• Ice and heat. For the first 24-72 hours after injury, you should ice your bicep. “It will slow down nerve conduction speed, which provides temporary pain relief and helps reduce inflammation,” advises Dr. Schaner. Apply ice for 20 minutes at a time, several times a day, to keep swelling down. After that, you’ll likely want to switch to heat, which brings more blood flow to the area and can help to relax tight bicep muscles. It’s also fine to experiment a bit. “Some patients report that they do really well when they alternate 10 minutes of ice with 10 minutes of heat,” says Dr. Schaner. 

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for arm pain. It’s generally best to avoid using these medications in high doses and for long periods of time. But if you’re in a lot of pain or your symptoms are limiting your function and movement, talk to your doctor about whether it’s safe for you to use them. Another option is an over-the-counter topical NSAID cream like diclofenac (Voltaren), which may also help reduce inflammation. 

• Surgery. If you have severe pain and swelling, to the point where you have a very limited range of motion, you may need to see an orthopedic specialist, says Dr. Schaner. They can do a physical exam and order tests such as x-rays or even an MRI to determine the severity of your bicep strain. “If it’s completely torn, you may need surgery,” explains Dr. Schaner. Keep in mind that even if you do need surgery, physical therapy is still a crucial part of your healing. After surgery, you’ll need about six to eight weeks of physical therapy to learn how to strengthen and stretch out the muscle, notes Dr. Schaner.  

How to Prevent Bicep Strains

There are a few things you can do to help prevent bicep strains. Here’s what Hinge Health physical therapists recommend. 

• Load up gradually. This is especially important when strength training, says Dr. Schaner. Don’t accelerate weights too quickly, even if it seems easy. “Your biceps still need to get used to your new loading capacity,” she explains. 

• Be mindful of repetitive motions. We know it’s hard — especially if it’s your job. But if you do have a lot of repetitive motion throughout the day, Dr. Schaner recommends adding stretching or movement breaks. “Anything you can do to open your arms out to the side will help relieve strain,” she stresses. Try a doorway stretch or an overhead reach to open up your arms and chest and restore range of motion. 

• Don’t skip the warmup. This is for anything that requires a lot of bicep use. “You may not think about warm-up exercises when it comes to, say, yard work, but lifting and carrying things like mulch can certainly take a toll on bicep muscles,” Dr. Schaner explains. Try some of the exercises listed above. 

• Stay strong. Make sure you include your biceps into your everyday workouts. Try to throw all of the above exercises into your resistance training program each week. 

PT Tip: Listen To Your Body

“There are usually some signs that your body gives you before a bicep strain happens,” points out Dr. Schaner. If your biceps feel tight or achy, back off a bit. Do some gentle stretches, drink some water, and then go back to your activity. “When I work with patients who have bicep strain, nine times out of 10 they tell me that they felt something funny, but pushed through to finish whatever they were doing,” says Dr. Schaner. “But that’s when you — and your biceps — will run into trouble. It’s better to take a break, whether it’s for a few minutes, a few hours, or even for a few days.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Athwal, G. S. (2021, October). Biceps Tendinitis. AAOS -- OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/biceps-tendinitis/

2. James N. Robinson . (2024, June 17). Muscle Strain: What You Need to Know About Pulled Muscles. Hospital for Special Surgery. https://www.hss.edu/conditions_muscle-strain.asp

3. Simons, S. M., & Dixon, J. B. (2024, February 29). Biceps tendinopathy and tendon rupture. UpToDate; MediLib. https://medilib.ir/uptodate/show/229

4. Varacallo, M., & Mair, S. D. (2020). Proximal Biceps Tendinitis and Tendinopathy. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK533002/

5. Zabrzynski, J., Gagat, M., Paczesny, L., Grzanka, D., & Huri, G. (2020). Correlation between smoking and neovascularization in biceps tendinopathy: a functional preoperative and immunohistochemical study. Therapeutic Advances in Chronic Disease, 11, 204062232095641. doi:10.1177/2040622320956418

6. Koltyn, K. F., Brellenthin, A. G., Cook, D. B., Sehgal, N., & Hillard, C. (2014). Mechanisms of Exercise-Induced Hypoalgesia. The Journal of Pain, 15(12), 1294–1304. doi:10.1016/j.jpain.2014.09.006