The most common symptoms of biceps tendonitis are pain the front of the shoulder that moves down the arm, a popping sensation in the shoulder, and weakness. Often, these symptoms can be relieved with a combination of rest (no overhead motion), ice, nonsteroidal anti-inflammatory medication, cortisone, and physical therapy. However, in some cases, surgery may be necessary. Most instances of biceps strain or tendonitis occur in conjunction with other problems, such as arthritis in the shoulder joint, chronic shoulder instability, or shoulder impingement. If left untreated, the tendon itself can grow larger or thicker. Sometimes this can cause a tendon tear and a bulge to appear in the upper arm. Swimmers, tennis players, and baseball players have a high risk for developing a biceps strain or tendonitis because of the repetitive shoulder motions necessary in their sport. Physical therapy treatment for a biceps strain or tendonitis will involve specific stretching and strengthening exercises designed to restore shoulder range of motion, flexibility, and strength. Physical therapy following surgery to repair a biceps strain or tendonitis will include protective devices such as a sling and therapeutic exercises and stretches to restore range of motion and prevent stiffness from disuse.