Pain guide · Shoulder pain

Shoulder pain when doing bicep curls: the biceps tendon, swinging, elbows drifting and swaps

Shoulder pain when you do bicep curls usually sits at the front of the shoulder, where the long head of the biceps tendon runs through a groove into the joint, and it often comes with an ageing or irritated rotator cuff. It tends to flare at the bottom of incline or drag curls, when your elbows drift forward at the top, or after a jump in weight or sets. No study has counted shoulder pain from curls or measured the elbows drifting forward, so this guide says where its advice comes from. Keeping your elbows by your sides, stopping before they drift, no swinging, lighter weights and seated or cable curls for a while usually help.

This guide starts with the signs that need help, from a 999 call for shoulder or arm pain with chest tightness or breathlessness, to a same-day check through the National Health Service's 111 line (NHS 111) or a general practitioner (GP) for a pop with a bulge in the upper arm, sudden weakness or a shoulder that looks out of place. It then maps the causes by where it hurts, explains what the studies of the biceps at the shoulder show, and don't, shows how to change your curls today, and gives a three-stage plan with a 3D demo of every move, from still holds back to incline curls.

3-stage exercise plan When to get help 34 sourcesUpdated 28 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.
Call 999: shoulder or arm pain with chest pain that feels tight or squeezing, or chest pain that spreads to your arms, neck or jaw, especially with shortness of breath, sweating or feeling sick. It could be a heart attack.
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
Call 999: you suddenly can't fully lift both arms and keep them there, because of weakness or numbness in one arm, especially if one side of your face droops or you slur your words or sound confused. It could be a stroke. Call even if the signs have stopped.
Same day (GP or NHS 111): a sudden pop or snap with pain at the shoulder or upper arm during a lift, with or without a bulge low in the upper arm. It's usually a torn long head of the biceps. Most need no operation, but the rotator cuff can tear at the same time.
Same day (an urgent treatment centre or A&E): a pop at the front of the elbow, with bruising and a bulge in the upper arm, is a different tear. Don't wait for it to settle: a torn biceps tendon at the elbow is best repaired within the first 2 to 3 weeks. If it happened weeks ago, still get it checked: repair is often still possible, though it may need a tendon graft.
Same day (GP or NHS 111): sudden weakness lifting the arm after an injury or fall. A rotator cuff tear caused by an injury needs urgent referral to a shoulder specialist. After a dislocation in anyone over 40, the rotator cuff should be checked: about 40% have a tear.
Same day (GP or NHS 111): sudden or very bad shoulder pain; you cannot move your arm; the arm or shoulder is badly swollen or has changed shape; pins and needles that do not go away; no feeling in the arm; the arm is hot or cold to the touch; pain that started after an injury such as a fall; or severe pain in both shoulders.
Same day (GP or NHS 111): the shoulder or arm is hot, swollen or red, or you have a high temperature (although not everyone has one) or feel unwell. A joint infection needs same-day care.
Same day: clumsiness in your hands, or numbness, pins and needles or weakness in one or both arms, that is getting worse; problems with balance or walking since the neck pain started; or neck pain with a severe headache.
Same day (urgent GP appointment or NHS 111): severe neck pain that starts suddenly or gets worse quickly; heaviness or weakness in the arms or legs; pins and needles in an arm along with neck or arm pain; or pain between the shoulder blades.
Same day (call NHS 111, or go to A&E if you feel very unwell): after a big or unusual session, such as hundreds of pull-ups, push-ups, dips or curls, a challenge or a new class, muscle pain, swelling or weakness far worse than the session explains, and dark pee (red, brown, tea or cola coloured), sometimes starting hours or days later. Dark pee isn't always there, so muscles far sorer, more swollen or weaker than the session explains still need the same-day check. It can be rhabdomyolysis, a breakdown of muscle that can harm the kidneys.
Same day (NHS 111): your arm hurts when you exercise, but the pain goes away when you rest.

See a doctor or physiotherapist if

Pain that is getting worse or has not improved after 2 weeks of looking after it yourself, or it is very hard to move your arm. In many areas you can refer yourself to physiotherapy.
Your shoulder has partly or fully come out of joint, or you worry it might.
Pins and needles or a cold arm alongside neck pain, or a new loss of strength or feeling in the arm that you cannot explain (a possible nerve problem).
Painful clicking or snapping at the front of the shoulder, or a feeling of something slipping there. The tendon can slip out of its groove, usually alongside a rotator cuff tear, so ask for an assessment.
Not clearly better after about 3 months of a good exercise programme, or it keeps coming back: ask about a specialist opinion.
Pain on top of the shoulder with no injury that hasn't eased after 6 to 12 weeks of changing your training: ask a GP or physiotherapist for an assessment.
A pop at the elbow some time ago, and weakness turning your palm up or bending the elbow that hasn't come back: see a GP soon, even if it no longer hurts. A torn tendon can stop hurting before it's mended.
A past history of cancer, an unexplained lump or swelling, weight loss, or pain that is constant and does not ease when you change position.
See a GP if you have pain and stiffness for more than a week, especially if you're over 50, it's in both shoulders (often the neck and hips too) and the stiffness lasts longer than 45 minutes in the morning. It can be polymyalgia rheumatica.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

The front of the shoulder, in the groove at the top of the arm, worse at the bottom of incline or drag curls, as your elbows drift forward, or reaching back or overhead, and tender to press

Usually the long head of the biceps tendon, often alongside the rotator cuff: the commonest pattern with curls.

Read: Biceps tendinitis (shoulder) →The outside of the upper arm, a painful arc lifting the arm out to the side, worse with raises and presses or lying on it at night

Usually the rotator cuff (subacromial pain), the commonest shoulder pain overall.

Read: Shoulder impingement (rotator cuff pain) →The top of the shoulder, on the bump at the end of the collarbone, worse with bench, dips or reaching across

Usually the acromioclavicular (AC) joint, more often from pressing than from curls.

Read: AC joint injury and pain →Deep in the shoulder with clicking, catching or a dead arm, in an overhead athlete or after a fall or a heavy pull

Possibly a tear of the rim of the socket where the biceps attaches (a SLAP tear), which is uncommon.

Read: SLAP tear →A sudden pop or snap at the shoulder or upper arm during a curl, then bruising towards the elbow and a bulge low in the arm

Usually a torn long head of the biceps: get it checked the same day, as the warning signs say.

Read: Biceps tendinitis (shoulder) →A pop at the front of the elbow, with bruising and a bulge in the upper arm

A different tear, at the elbow, which is best repaired early: see the warning signs.

Read: Front of the elbow (biceps tendon) →Weakness lifting or turning the arm out, especially after a fall or in later life

Possibly a rotator cuff tear.

Read: Rotator cuff tear →The neck, the top of the shoulder blade and down past the elbow, with pins and needles

A nerve in the neck rather than the shoulder.

Read: Pinched nerve in the neck →The tops of the shoulders and neck, as your shoulders shrug up on heavy curls

Usually the upper trapezius (our reading). Shoulders down, lighter weights.

Read: Neck and shoulder pain →Under or around the shoulder blade during curls

The shoulder-blade muscles, or pain referred from the neck.

Read: Pain under the shoulder blade →An even ache in the front of both upper arms a day or two after a new or heavy session

Usually muscle soreness, which fades within about a week.

Read: Upper arm pain →The elbow crease, the inner or outer elbow, or the wrist

The elbow or the wrist rather than the shoulder: our elbow and wrist curl guides cover them.

Read: Elbow pain in bicep curls →The back of the shoulder

Usually the rotator cuff or the back of the joint.

Read: Back of shoulder pain →

Shoulder or arm pain with chest tightness or breathlessness, or arm pain with exercise that eases with rest

Possibly the heart: see the warning signs at the top of this page.

Understand it

What a curl asks of the shoulder: the biceps crosses itMixed evidence

A curl bends the elbow against a weight while the upper arm stays by your side or rests on a pad. The biceps has two heads: the short head starts on a hook at the front of the shoulder blade, and the long head's tendon runs through a groove at the front of the upper arm bone and into the joint, to the top of the socket. So the biceps crosses the shoulder as well as the elbow.

How much it works at the shoulder is disputed. With the elbow locked straight in a brace, fine-wire recordings found no activity in the long head during shoulder movement (10 shoulders); surface recordings in 13 volunteers found low activity that rose as the arm lifted and with a 1 kg load at the elbow; and in 11 people the biceps was active in every shoulder movement tested and seemed to steady the top of the arm bone. When the biceps was stimulated in 30 people, its pull to raise the arm was greatest with the arm by the side and the elbow nearly straight, and near zero once the arm was raised 60 degrees or more.

Sources 1, 2, 3, 4, 5

Curl position, grip and swinging: what the lab studies show, and don'tEmerging evidence

In 10 bodybuilders, the front of the shoulder (the anterior deltoid) worked 6% to 9% harder with palms-down and thumb-up (hammer) grips than palms up, which the authors put down to steadying the arm bone. So a hammer curl isn't automatically kinder to a sore front of the shoulder (our reading). In 22 people, standing and incline curls worked the biceps hardest late in the lift and preacher curls early; in a 10-week trial, curling with the shoulder in front of you or behind you built the same muscle and strength.

In 25 untrained adults, swinging curls built as much arm muscle as strict curls, and no injuries were reported. No study has measured the elbows drifting forward, swinging or curl type against shoulder pain. That the bottom of an incline or drag curl stretches the long head over the front of the shoulder, and that drifting elbows bring the front of the shoulder in, is our reading of these studies, as the site's biceps tendinitis guide and the incline curl's move page say.

Sources 6, 7, 8, 9

Who gets itEmerging evidence

In 1,387 gym users, the shoulder was by far the commonest painful area; 20% of those who did dumbbell curls, 18% on the curl machine and 13% with a barbell linked the exercise to their pain, without saying where it hurt. A narrative review found up to 36% of reported resistance training injuries at the shoulder. In 46 weight trainers and 31 non-lifters, signs of rotator cuff pinching were commoner in the lifters, and went with side raises and upright rows above shoulder height rather than curls.

In 406 shoulder scans (average age 55), long head tendon changes rose by about 4% for each year of age, and any rotator cuff problem made a long head problem about 7 times more likely. The American Academy of Orthopaedic Surgeons (AAOS) says biceps tendinitis usually comes with other shoulder problems such as rotator cuff wear, from a lifetime of normal use made worse by repeated overhead work. It tends to bother lifters from about 40, after a jump in curling, or with incline, drag or Bayesian curls new to a programme (our reading).

Sources 10, 11, 12, 13, 1

How it's recognised, and what tests and scans can't tell youStrong evidence

Biceps tendon pain sits at the front of the shoulder, worse lifting overhead or reaching back (a seatbelt or a coat), sometimes with an ache down the upper arm or a snapping feeling, and the groove is tender to press. The tests are weak on their own: in 100 shoulders checked during surgery, Speed's test picked up 74% of biceps problems but was positive in more than half of normal tendons, and Yergason's picked up only 42%. In 246 shoulders, 65% to 75% of healthy tendons could be wrongly called abnormal by the examination and ultrasound signs used, and no single shoulder test makes the diagnosis.

A scan isn't needed at first. The AAOS says ultrasound and magnetic resonance imaging (MRI) show the tendon in more detail than X-rays. A scan matters after a pop with a bulge (in 116 people with that bulge, 85% also had a rotator cuff tear on MRI), after sudden weakness or a fall, or if pain hasn't eased after about 3 months of good exercise.

Sources 1, 14, 15, 16, 17

How it usually goesStrong evidence

The NHS says shoulder self-care usually takes about 2 weeks to start helping and that it can take 6 months or longer to recover; NHS inform says many new shoulder problems begin to settle within 6 weeks. Across 16 studies, about half of new shoulder problems had fully recovered within 6 months, and in 101 GP patients, half still had some complaints at 26 weeks, though many of them felt cured.

After a torn long head, the AAOS says the pain usually goes away over time and most people return to their activities without limits; without repair, people lost on average 21% of their palm-up turning strength and 8% of their elbow bending strength. For tears of the rim of the socket (SLAP tears) treated without surgery, 78% of athletes who completed their rehabilitation got back to their sport. No one can promise a date.

Sources 18, 19, 20, 21, 22, 23, 24

What helps, and how strong the evidence is

Strength work is the treatment, though biceps tendon pain has no trialEmerging evidence

A 2024 review found 14 articles on physiotherapy for biceps tendon pain at the shoulder, mostly on treatments such as shockwave and laser, and no exercise trial. In a structured survey of 29 international experts, they agreed on gradual loading, with exercise, hands-on treatment and education. So the plan borrows from rotator cuff pain, labelled as such.

In 102 people with long-standing rotator cuff pain who had been referred for surgery, 12 weeks of specific rotator cuff and shoulder-blade exercise gave 69% a good result against 24% with general exercise. Across 22 trials (1,281 people), exercise focused on shoulder control reduced disability a little more than general exercise in the short term, on moderate-certainty evidence.

Sources 25, 26, 27, 28

Supervised exercise or one good advice session: similar resultsStrong evidence

In 708 people with rotator cuff pain, a progressive physiotherapy programme did no better than one best-practice advice session over 12 months, and a steroid injection didn't help either. So the plan on this page, done at home within the pain rule, is a reasonable start, and a physiotherapist helps if it isn't working.

Source 29

Elbows by your sides and no swing: sensible, but untested for painEmerging evidence

The site's bicep curl guide says keep your elbows close to your sides and stop when your forearms are about upright, before your elbows drift forward; if your elbows swing forward or your shoulders lift, the weight is too heavy. That fits the biceps' pull on the shoulder being greatest with the arm by the side, but no study has tested it for pain. Swinging curls caused no reported injuries in one trial; keeping reps strict while your shoulder is sore is our suggestion, so you can judge the load.

Swapping incline and drag curls for seated, cable or machine curls with the elbow by the side is the site's biceps tendinitis guide's editorial advice. A hammer grip worked the front of the shoulder slightly harder in one study, so choose the grip by what passes the pain rule.

Sources 5, 9, 6

A torn long head usually needs no operationEmerging evidence

The AAOS says long head tears rarely need surgery and almost never for appearance alone; mild weakness and the bulge don't bother most people. Without repair, people lost about a fifth of their palm-up turning strength. Because the rotator cuff is often torn too, a pop with a bulge still needs a same-day check.

Sources 22, 23, 17

SLAP tears: non-surgical care firstEmerging evidence

The AAOS says non-surgical care is the first treatment for SLAP tears. Across 5 studies of 244 athletes, 53.7% returned to play without surgery, 78% of those who completed their rehabilitation; in another series of 39 people, about half chose surgery in the end. After a repair, 77.5% of athletes returned to sport, at an average of about 8 months. Weightlifting was among the commonest sports in these studies, but curls weren't studied.

Sources 30, 24, 31, 32

Injections, painkillers and surgeryEmerging evidence

The AAOS lists avoiding painful activities, ice, anti-inflammatory medicines, steroid injections (often with ultrasound guidance) and physiotherapy, with surgery if it doesn't improve. In rotator cuff pain, a steroid injection added nothing over a year in a large trial. The NHS suggests paracetamol or ibuprofen, heat or cold and staying active, and says do not make up your own strenuous exercises or use heavy gym equipment while it is sore.

Sources 1, 18, 29

How much pain is OK while you exercise?

Up to about 5 out of 10, back to where it was by your next sessionEmerging evidence

This guide uses the shoulder hub's rule, as our biceps tendinitis, lateral raise and upright row guides do. During shoulder strengthening, pain up to about 5 out of 10 is acceptable, and a little is expected. By your next session it should be back to where it was before. If it isn't, use a lighter band or weight or a smaller range next time, not nothing.

This is how the Holmgren trial set each person's load: pain was not allowed above 5 out of 10 during the exercises, and any increase had to settle back to the starting level before the next session; otherwise the load came down. If pain climbs week on week, or a warning sign appears, stop and get it checked.

The biceps experts add that the load should match how irritable the tendon is. In 7 trials of long-lasting muscle and joint pain, exercise that allowed some pain did no worse than pain-free exercise. For curls (our suggestion, built on the same rule): judge each set by its last reps, and choose the curl, grip, range and load where the front of your shoulder stays at 5 out of 10 or less and is back to where it was by your next session.

Elbow pain follows the stricter elbow rule in our elbow curl guide. A pop, a bulge, sudden weakness, tingling down the arm or chest symptoms aren't pain-rule questions: see the warning signs.

Sources 27, 26, 33

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Keep curling, change the curl

About weeks 0 to 2: keep the arm training within the pain rule with your elbows by your sides and no stretch at the front of the shoulder, and start the rotator cuff and shoulder-blade work. With a pop, a bulge or sudden weakness, get checked first; with a diagnosed tear or after surgery, that guide's plan or your team's comes first.

Dumbbell biceps curl demonstrated on the 3D figure

3D demoDumbbell biceps curlBeginner · A dumbbell

Hold still, elbow at a right angle and by your side, light weight: 5 holds of 30 to 45 s, once a day · As in our biceps tendinitis guide (editorial); the biceps experts back still holds

Easier: Seated dumbbell curl · Harder: Incline inner biceps curl

Seated dumbbell curl demonstrated on the 3D figure

3D demoSeated dumbbell curlBeginner · A dumbbell + A bench or box

2 to 3 sets of 10 to 15, light, elbows by your sides, through the middle of the range, stopping 2 or 3 reps short · Editorial. Sitting stops the swing

Harder: Dumbbell biceps curl

Standing band external rotation demonstrated on the 3D figure

3D demoStanding band external rotationBeginner · A band + An anchor point

3 sets of 15, light band, elbow at your side, within the pain rule · The Holmgren trial's sets and repetitions; the exercise is our choice, as in our biceps tendinitis and lateral raise guides

Easier: Stick-assisted external rotation (lying) · Harder: Side-lying external rotation

3D demoBand rowBeginner · A band + An anchor point

3 sets of 10 to 15, stopping 2 to 3 reps short of failure, with 60 to 90 seconds' rest · The move page's dose (an editorial starting point)

Harder: Supported single-arm dumbbell row

Scapular push-up (push-up plus) demonstrated on the 3D figure

3D demoScapular push-up (push-up plus)Beginner · No equipment

2 to 3 sets of 10, on a wall or bench first · As in our bench press and lateral raise shoulder guides (editorial)

Easier: Dumbbell shoulder-blade punch · Harder: Push-up

Table slide (seated forward reach) demonstrated on the 3D figure

3D demoTable slide (seated forward reach)Beginner · A bench or box

10 slow repetitions, once or twice a day, only if lifting the arm is sore · Within the move page's dose, as in our biceps tendinitis guide

Easier: Pendulum exercise (Codman's pendulum) · Harder: Overhead lat stretch at a bench (elbows on the bench)

Move on when: Daily life and the stage 1 moves pass the pain rule for a week, and the holds no longer raise the pain (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build: lift and lower, rotator cuff and shoulder blade

About weeks 2 to 6, curls 2 or 3 times a week and the cuff work 3 to 5 days a week: load the biceps through both its jobs, bending the elbow and lifting the arm forwards, and build the rotator cuff and shoulder blade, as the expert panel advises.

3D demoDumbbell biceps curlBeginner · A dumbbell

3 sets of 15, lifting in 1 s and lowering over 3 to 4 s, elbows by your sides · As in our biceps tendinitis guide (the tempo and dose of the only exercise case series it cites; choosing a curl is editorial)

Easier: Seated dumbbell curl · Harder: Incline inner biceps curl

Standing cable curl demonstrated on the 3D figure

3D demoStanding cable curlBeginner · A cable machine

2 to 3 sets of 10 to 15, stopping 2 or 3 reps short, elbows by your sides · Editorial, as in our elbow curl guide: a cable lets the load rise in small steps

Harder: Dumbbell biceps curl

Side-lying external rotation demonstrated on the 3D figure

3D demoSide-lying external rotationBeginner · A dumbbell

3 sets of 15, lowering over about 3 s · The Holmgren trial's sets and repetitions, as in our lateral raise guide

Easier: Standing band external rotation · Harder: Cuban rotation

Scaption raise demonstrated on the 3D figure

3D demoScaption raiseBeginner · A dumbbell

3 sets of 15, thumbs up, to shoulder height or just below any painful point, lowering over about 3 s · As in our lateral raise and biceps tendinitis guides (the trial's sets and repetitions; editorial exercise)

Easier: Band lateral raise · Harder: Smith machine upright row

Front raise demonstrated on the 3D figure

3D demoFront raiseBeginner · A dumbbell

2 to 3 sets of 10 to 12, thumbs up, to shoulder height, lowering over 3 s · As in our biceps tendinitis guide (editorial): it loads the long head as the arm lifts forward

Easier: Band lateral raise · Harder: Smith machine upright row

Prone Y-T-W raises demonstrated on the 3D figure

3D demoProne Y-T-W raisesBeginner · No equipment

2 to 3 rounds of 8 · As in our lateral raise and biceps tendinitis guides (editorial)

Easier: Wall angel · Harder: Bent-over reverse fly

Move on when: 3 sets of 15 slow curls and the cuff work pass the pain rule, with your shoulder back to usual by the next session, for a week, and reaching overhead and behind you is comfortable day to day (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Back to your usual curls

From about week 6, often later: the bar, the hammer grip and then the curls that stretch the front of the shoulder, one change at a time by the written steps below. No study has tested a return to curls after shoulder pain, so the order is editorial.

EZ-bar curl demonstrated on the 3D figure

3D demoEZ-bar curlIntermediate · EZ curl bar

3 sets of 8 to 12, stopping 2 or 3 reps short · The dose our bicep curl guide gives for the pull day workout (editorial)

Easier: Seated dumbbell curl · Harder: Chin-up

Hammer curl demonstrated on the 3D figure

3D demoHammer curlBeginner · A dumbbell

3 sets of 8 to 12 · As in our biceps tendinitis and elbow curl guides (editorial)

Easier: Seated dumbbell curl · Harder: Alternating hammer curl

Preacher curl demonstrated on the 3D figure

3D demoPreacher curlIntermediate · A barbell + A bench or box

2 to 3 sets of 8 to 12, lowering under control, never bounced into straight arms · As in our elbow curl guide (editorial)

Easier: Seated dumbbell curl · Harder: Chin-up

Incline dumbbell curl demonstrated on the 3D figure

3D demoIncline dumbbell curlIntermediate · A dumbbell + A bench or box

3 sets of 10 to 15, last, once the others pass the pain rule · The dose our bicep curl guide gives for pull day B (editorial). Ease off if the front of the shoulder aches in the stretch, as the move page says

Easier: Seated dumbbell curl · Harder: Chin-up

Cable external rotation demonstrated on the 3D figure

3D demoCable external rotationBeginner · A cable machine

3 sets of 10 to 12, heavier than in stage 2 · As in our lateral raise and biceps tendinitis guides (editorial)

Harder: Side-lying external rotation

3D demoFace pullIntermediate · A band

3 sets of 12 to 15 · As in our lateral raise guide (editorial)

Easier: Prone Y-T-W raises · Harder: Tuck back lever

Move on when: Your usual curl sessions pass the pain rule for 2 weeks. Keep the cuff and shoulder-blade work twice a week, since this tendon rarely gets irritated on its own, and if it flares after a big session, go back a stage for a few days, not to nothing (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Your curl for now (written steps)

Our 3D figure can't show where your elbows drift, how much you swing or where in the range the shoulder catches. These steps come from the site's bicep curl and biceps tendinitis guides, lab studies and the NHS; no trial has tested a change to the curl for shoulder pain, and each step names its source or says it is our suggestion.

1. Elbows by your sides, just in front of your hips, shoulders relaxed and down; stop when your forearms are about upright, before your elbows drift forward (the site's bicep curl guide).
2. No swing, no leaning back and no cheat reps for now: strict reps make the load easier to judge (the site's curl guide; our suggestion).
3. Load: a weight you can curl 10 to 15 times without swinging, 2 or 3 sets, and about half your usual biceps sets for 1 to 2 weeks, counting chin-ups and rows (the site's curl guide for the load; our suggestion for the volume).
4. Curl type: seated, standing, cable or machine curls with your elbow by your side; leave incline, drag and Bayesian curls for later (the site's biceps tendinitis guide, editorial).
5. Grip: whichever keeps the front of your shoulder within the pain rule; a hammer grip isn't automatically easier on the shoulder (our reading of a small muscle activity study).
6. Range: lower under control to a nearly straight arm; if the bottom catches at the front of the shoulder, train the middle of the range first (our suggestion).
7. Breathing: breathe out as you curl; heavy curls to failure raise blood pressure sharply (our suggestion, from a lab study).
8. The rest of your week: fewer heavy chin-ups, less overhead pressing, side raises and upright rows below shoulder height, and the rotator cuff work added (the site's biceps tendinitis guide; a study of lifters).

Sources 5, 6, 9, 34, 12

Keep the shoulder moving

The NHS says stay active and gently move your shoulder, don't completely stop using it, and try shoulder exercises for 6 to 8 weeks to stop the pain returning; heat or cold packs for up to 20 minutes and paracetamol or ibuprofen can help you keep moving. NHS inform says that after the first 48 hours, try to use your shoulder more, because exercise really helps.

Sources 18, 19

Back to your usual training (written steps)

No study has tested how curls come back after shoulder pain, so these steps are our suggestion unless a source is named.

1. One change at a time: the bar, then the hammer grip, then preacher curls, then incline, drag and Bayesian curls, then heavier loads and cheat reps if your programme uses them.
2. Add load in small steps, only after a session that passed the pain rule.
3. Chin-ups, deep or wide bench pressing, dips and overhead pressing come back last, as our biceps tendinitis guide says.
4. Everyday life: carry shopping with your arm by your side and close to your body, reach back for a seatbelt or coat with the other hand at first (the AAOS names these as painful), and rest the arm on a cushion when sitting (the NHS).
5. Keep the rotator cuff and shoulder-blade work twice a week for the long term.

Sources 1, 18

Positions to swap, and why

Habit or position	Why it matters	Instead
Incline curls with pain at the front of the shoulder	Your arm hangs behind you, stretching the long head over the front of the shoulder, as the move page and our biceps tendinitis guide say.	Seated curls with your elbows by your sides.Try: Seated dumbbell curl
Drag curls with pain at the front of the shoulder	The move page says keep your elbows by your sides in a standard curl if the front of the shoulder aches as your elbows go back.	Cable curls with your elbows by your sides.Try: Standing cable curl
Letting your elbows drift forward at the top	The front of the shoulder takes over; the site's curl guide says stop before your elbows drift (untested for pain).	Stop when your forearms are about upright.
Swinging and cheat curls while it's sore	No evidence a swing injures, but strict reps make the load easier to judge (our suggestion).	Strict, lighter curls, or preacher curls on a pad if they are comfortable.Try: Preacher curl
Heavy chin-ups on top of curls	A high load on the biceps while it's irritable, as our biceps tendinitis guide says.	A pulldown to the front.Try: Lat pulldown
Upright rows above shoulder height	Raises and upright rows above shoulder height went with rotator cuff pinching signs in lifters.	Face pulls and rows.Try: Face pull
Resting the arm until it stops hurting	The NHS says don't completely stop using your shoulder.	Still holds and band work from the start.Try: Standing band external rotation
Curling on after a pop, a bulge or sudden weakness	It may be a torn tendon, sometimes with a rotator cuff tear.	Stop and get it checked the same day.
Pushing on through tingling down the arm	That points to a nerve in the neck rather than the shoulder.	Stop that exercise and get it assessed.

Routines to follow

Bicep workout: curls with your arm in three positions, plus hammer curls

A 30-minute biceps session: an EZ-bar curl, an incline curl, a preacher curl and hammer curls, about 10 hard sets, in the gym or with dumbbells.

30 minIntermediate6 movesA dumbbell, EZ curl bar

Arm workout

Biceps, triceps and forearms: curls, hammer curls, skull crushers, pushdowns, concentration curls and dips.

35 minBeginner7 movesA dumbbell, A bench or box

Arm workout at home: curls and triceps with dumbbells

A 30-minute arm workout at home with dumbbells: curls, hammer curls and concentration curls paired with overhead extensions, close-grip push-ups and kickbacks.

30 minBeginner8 movesA dumbbell

Shoulder mobility and rotator cuff routine (with a band)

A 25-minute band routine for healthy shoulders: move the shoulder and upper back through their range, then strengthen the rotator cuff and shoulder blades.

25 minBeginner12 movesA wall, A band

Pull day workout

A pull day workout for back and biceps: pull-ups, barbell rows, chest-supported rows, face pulls and curls, with sets, reps and rest.

55 minIntermediate10 movesPull-up bar, A barbell

Upper back mobility routine

A 12-minute routine for a stiff upper back and rounded shoulders: chin tucks, wall angels, Y-T-W raises and open books.

12 minBeginner8 movesA foam roller, A wall

More moves for this area

Questions people ask

Why does my shoulder hurt when I do bicep curls?

Usually the long head of the biceps, whose tendon runs over the front of the shoulder, especially at the bottom of incline or drag curls or when your elbows drift forward at the top. It often comes with the rotator cuff. Elbows by your sides, no swing, lighter weights and seated or cable curls for a while usually help.

Why does the front of my shoulder hurt when I curl?

A tender spot in the groove at the front of the shoulder, worse reaching back or overhead, points to the biceps tendon. Our biceps tendinitis guide covers the condition; this guide covers changing your curls.

Can bicep curls cause shoulder pain?

They can bring it on, mostly when the load or the stretch at the front of the shoulder jumps: more sets, heavier weights, or a new incline or drag curl. No study has counted it, but in a gym survey 13% to 20% of people who curled linked curls to training pain.

Is it my rotator cuff or my biceps tendon?

Often both: a rotator cuff problem made a biceps tendon problem about seven times more likely in one scan study. Biceps pain sits at the front, rotator cuff pain more on the outside of the upper arm with a painful arc. The same plan helps either.

Why does my shoulder hurt on incline curls?

Your arm hangs behind you, stretching the long head of the biceps over the front of the shoulder, and the move page says ease off if it aches. Swap to seated or cable curls and bring incline curls back last.

Are hammer curls better for shoulder pain?

Not necessarily: the front of the shoulder worked slightly harder with a hammer grip in one small study. Use the grip that keeps pain at 5 out of 10 or less.

Does swinging the weight hurt my shoulder?

One trial found swinging curls built as much muscle as strict curls, with no injuries reported. While your shoulder is sore, keep reps strict so you can judge the load.

I felt a pop at my shoulder and now there's a bulge in my upper arm. What now?

That is usually a torn long head of the biceps: get it checked the same day, because the rotator cuff can tear at the same time. Most need no operation. A pop at the front of the elbow is a different tear that is best repaired early.

Should I stop doing curls?

Usually not: change them. The NHS says don't completely stop using your shoulder, and experts load the biceps tendon gradually. Start with holds and light seated curls and build back with the plan on this page.

Do I need a scan?

Not at first: examination tests and scans often call healthy biceps tendons abnormal. A scan matters after a pop with a bulge, sudden weakness after a fall, or pain that hasn't eased after about 3 months of good exercise.

How long will it take?

No one can promise a date. The NHS says self-care takes about 2 weeks to start helping and recovery can take 6 months or longer, and about half of new shoulder problems have fully recovered by 6 months.

When should I see a doctor?

Call 999 for shoulder or arm pain with chest tightness or breathlessness, or sudden weakness in one arm with a drooping face. Get help the same day for a pop with a bulge, sudden weakness, a shoulder that looks out of place, or a hot, swollen shoulder, and see a GP if it isn't better after 2 weeks of self-care. In the US, call 911 where this page says 999.

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.

When to get help first

Get urgent medical help if

See a doctor or physiotherapist if

Where does it hurt?

Understand it

What a curl asks of the shoulder: the biceps crosses itMixed evidence

Curl position, grip and swinging: what the lab studies show, and don'tEmerging evidence

Who gets itEmerging evidence

How it's recognised, and what tests and scans can't tell youStrong evidence

How it usually goesStrong evidence

What helps, and how strong the evidence is

Strength work is the treatment, though biceps tendon pain has no trialEmerging evidence

Supervised exercise or one good advice session: similar resultsStrong evidence

Elbows by your sides and no swing: sensible, but untested for painEmerging evidence

A torn long head usually needs no operationEmerging evidence

SLAP tears: non-surgical care firstEmerging evidence

Injections, painkillers and surgeryEmerging evidence

How much pain is OK while you exercise?

Up to about 5 out of 10, back to where it was by your next sessionEmerging evidence

The exercise plan: 3 stages

Keep curling, change the curl

Build: lift and lower, rotator cuff and shoulder blade

Back to your usual curls

What to change for now

Your curl for now (written steps)

Keep the shoulder moving

Back to your usual training (written steps)

Positions to swap, and why

Routines to follow

Bicep workout: curls with your arm in three positions, plus hammer curls

Arm workout

Arm workout at home: curls and triceps with dumbbells

Shoulder mobility and rotator cuff routine (with a band)

Pull day workout

Upper back mobility routine

More moves for this area

Questions people ask

Other pain guides

Sources