Not all forelimb lameness comes from the foot. Some cases of frustrating, persistent, and misunderstood sources of front-end lameness start higher—inside the shoulder. A commonly overlooked culprit: bicep tendon injuries (bicipital tenosynovitis).
These injuries limit reach, shorten stride, and steal power from the front end. Because they’re difficult to localize and often mistaken for hoof or cervical pain, many cases drag on for months before they’re properly diagnosed.
What Is the Equine Bicep Tendon?
The biceps brachii tendon originates on the scapula and runs through the bicipital groove of the humerus. It stabilizes the shoulder and absorbs concussion when the horse lands, which makes it heavily involved in jumping, stopping, turning, and collected work.
When injured, horses lose front-end lift, reach, and confidence.
How These Injuries Happen
Bicep tendon injuries develop in two major ways:
Repetitive Overload
Many cases are chronic overuse injuries caused by cumulative strain:
- Training that significantly loads the forehand
- Weakness in shoulder stabilizing muscles
- Long-term saddle imbalance or rider asymmetry
- Concussive footing
- Poor foot balance causing compensatory stress
- Fatigue-related mechanics over fences or patterns
- Lower cervical arthritis causing compensatory stress
Traumatic Injuries
These injuries can also occur suddenly due to forceful backward extension of the forelimb behind the shoulder joint, overstretching the tendon beyond tolerance.
- A slip or fall onto the shoulder
- A missed distance or awkward landing/takeoff
- Leg caught over a fence or trailer bar
- Violent pull-back when tied
- Rotational falls
Recognizing the Signs
Bicep tendon injuries do not often present like typical lower-limb soft tissue injuries. Instead, look for:
- Shortened reach in the front limb
- "Stabbing" or choppy trot
- Reluctance to land a specific lead off fences
- Inexplicable performance deficits (i.e., refusals, considerable number of rails, refusing to participate)
- Resistance picking up the canter lead
- Pain on palpation of the bicipital grove
- Difficulty lifting the leg for the farrier
- Intermittent lameness that improves with rest but returns with work
Diagnosis
These are diagnoseable injuries with the right approach. Work with a veterinarian using:
-
Ultrasound of the bicipital groove to evaluate fiber disruption
-
Diagnostic nerve blocks to confirm the pain source
-
Radiographs if bony involvement is suspected
-
MRI for complex or chronic cases
Shoulder injuries are often misdiagnosed—don’t skip imaging.
Treatment and Rehabilitation
Rest alone does not restore tendon function. Successful recovery requires controlled loading and progressive stability work.
Rehab priorities:
- Straight lines before lateral work and circles
- Stability
- Hill work
- Pole at the walk
- Consistency
- Flexibility
Prognosis
With early diagnosis and a disciplined rehab plan, prognosis for return to work is fair to good. Chronic cases or those with significant fiber disruption require more time but can still recover with structure and compliance.
Tendon injuries demand more than time—they demand structure. Whether you’re managing a bicep tendon injury or building a proactive soft tissue program, incorporating targeted tendon support during progressive loading helps improve repair quality and long-term durability. Tendonall is trusted by performance barns, veterinarians, and rehabilitation programs to support cleaner tendon recovery and stronger returns to work.
Equine Bicep Tendon Injuries: Diagnosis, Recovery, and Long-Term Soundness
Not all forelimb lameness comes from the foot. Some cases of frustrating, persistent, and misunderstood sources of front-end lameness start higher—inside the shoulder. A commonly overlooked culprit: bicep tendon injuries (bicipital tenosynovitis).
These injuries limit reach, shorten stride, and steal power from the front end. Because they’re difficult to localize and often mistaken for hoof or cervical pain, many cases drag on for months before they’re properly diagnosed.
What Is the Equine Bicep Tendon?
The biceps brachii tendon originates on the scapula and runs through the bicipital groove of the humerus. It stabilizes the shoulder and absorbs concussion when the horse lands, which makes it heavily involved in jumping, stopping, turning, and collected work.
When injured, horses lose front-end lift, reach, and confidence.
How These Injuries Happen
Bicep tendon injuries develop in two major ways:
Repetitive Overload
Many cases are chronic overuse injuries caused by cumulative strain:
Traumatic Injuries
These injuries can also occur suddenly due to forceful backward extension of the forelimb behind the shoulder joint, overstretching the tendon beyond tolerance.
Recognizing the Signs
Bicep tendon injuries do not often present like typical lower-limb soft tissue injuries. Instead, look for:
Diagnosis
These are diagnoseable injuries with the right approach. Work with a veterinarian using:
Shoulder injuries are often misdiagnosed—don’t skip imaging.
Treatment and Rehabilitation
Rest alone does not restore tendon function. Successful recovery requires controlled loading and progressive stability work.
Rehab priorities:
Prognosis
With early diagnosis and a disciplined rehab plan, prognosis for return to work is fair to good. Chronic cases or those with significant fiber disruption require more time but can still recover with structure and compliance.
Tendon injuries demand more than time—they demand structure. Whether you’re managing a bicep tendon injury or building a proactive soft tissue program, incorporating targeted tendon support during progressive loading helps improve repair quality and long-term durability. Tendonall is trusted by performance barns, veterinarians, and rehabilitation programs to support cleaner tendon recovery and stronger returns to work.