A long head of biceps tendon tear or injury is a common source of pain causing restricted overhead shoulder movements. It can get affected by injury, inflammation or wear and tear. It is common in overhead athletes such as fast bowlers or tennis players, when it can reduce the sports performance. It usually responds to a guided steroid injection and physiotherapy. In the case of persistent symptoms, your surgeon will advise surgical treatment in the form of longhead ofbiceps tenotomy or tenodesis. In severe cases it can lead to rupture of the tendon which can cause an obvious bulge in the arm called a Popeye sign and occasional cramps. It usually does not require surgical treatment, however your surgeon may offer you surgery (biceps tenodesis) if it is associated with a rotator cuff tear, or persistent symptoms of pain and cramps along the biceps tendon.