What is Bicep Tendinopathy?
Biceps tendinopathy is the umbrella term for biceps injuries that include:
- tendonitis/tendinitis (inflammed tendon).
- tendinosis (non-inflammed degenerative tendon).
- biceps tenosynovitis (inflammed tendon sheath).
- ruptured biceps tendon (secondary to degeneration or tear).
Having said that, old habits die hard, and the conditions have for many years been commonly referred to as biceps tendonitis or tendinitis. Your up-to-date physiotherapist or sports doctor will refer to this group of injuries as biceps tendinopathies or the specific injury itself after they have diagnosed the injury thoroughly.
Bicep Tendinopathy or Tendinitis
To understand biceps tendinopathy or tendonitis better, one must first understand the difference between tendonitis and tendinosis. Tendonitis refers to an acute injury accompanied by inflammation. Tendinosis refers to a chronic (longer term) injury in the absence of inflammation.
Causes of Biceps Tendonitis
Inflammation of the biceps tendon can be caused by:
- Repetitive motions from certain sports or work activities, especially if these motions cause the elbow to repeatedly bend, the wrist to repeatedly rotate while the palm is upturned, or with repetitive hyperextension of the elbow.
- Sudden increase in the intensity or amount of a particular activity that causes strain in the biceps tendon.
- A direct injury, like a fall in which you land on the shoulder or elbow.
What are the Symptoms of Bicep Tendinopathy?
Bicep tendonitis and tendinopathy sufferers will commonly report:
- Pain in the region of the anterior shoulder located over the bicipital groove, occasionally radiating down to the elbow.
- Overhead activities usually reproduce pain, especially those positions that combine abduction and external rotation eg cocking to throw.
- The pain is often aggravated by shoulder flexion, forearm supination, and/or elbow flexion.
- Some patients describe muscle weakness and clicking or snapping with shoulder movements.
- The symptoms are alleviated by rest and ice.
How is Bicep Tendinopathy Treated?
- Pain medication: anti-inflammatory medication can help if this is an acute episode
- Range of motion: a physical therapist can assist with assessing the amount of movement that you have within the shoulder and elbow joints to promote proper movement
- Strength: it is crucial to have the proper balance and stability of the supporting musculature. Often times, the muscles on the front part of the shoulder complex are over working causing the rest of the shoulder muscles to become inefficient
- Manual therapy: a physical therapist can perform joint mobilization techniques, soft tissue massage/mobility and other hands on treatment to restore balance to the affected arm
Bicep Tendinopathy Prevention
- Posture: it is important to make sure that your postural supporting muscles are working appropriately (see the muscle releases provided below)
- Strength: performing rotator cuff strengthening exercises correctly and on a regular basis
- Proper lifting/holding mechanics: remember to avoid carrying or lifting heavy objects away from the body. Keeping weight closer to the body will decrease the force at the joints and muscles
Exercises to Relieve Pain from Biceps Tendonitis
If you’re experiencing any of the symptoms associated with biceps tendonitis, you can try the exercises below. If your feelings of pain increase, stop immediately. While your tendon heals, be sure to avoid overhead lifting movements.
Flexion and Extension
- Flex and extend the elbow on your injured side by gently bringing the palm of your hand up to the shoulder.
- Be sure to bend the elbow as much as possible. Then straighten your arm and elbow.
- Complete 15 repetitions.
- Rest, and then complete another set of 15 reps.
Single Shoulder Flexion
- Begin by standing with your arms at your side.
- Keeping the injured arm straight, raise it forward and up until it points to the ceiling.
- Hold for about 5 seconds, and then return to the starting position.
- Complete another set with between 8 and 12 raises, holding each raise for 5 seconds.
- Face a wall, standing about 6 inches away.
- With your palm down, raise the arm on your injured side and touch the thumb side of your hand to the wall.
- Make sure your arm is straight, and then turn your body away from your raised arm until you feel a stretch in the biceps.
- Hold this stretch for about 15 seconds.
- Rest, and then complete 2 more reps.
Reclining External Rotation
- Lie down with your injured side facing up.
- Extend your other arm along the ground and rest your head against it. Bend your knees for comfort and stability.
- Rest your upper arm on your side and bend the elbow on your injured side to 90 degrees, with your palm facing in toward your body and your lower arm down toward the floor.
- Keep your elbow tucked against your body, and then raise your forearm until it’s parallel to the ground.
- Slowly lower it back down and repeat for 15 repetitions.
- Rest, and then complete another set. You can try this exercise with a light dumbbell or even a can of soup, building up the weight gradually.
- Lie on the injured side.
- Use a pillow for your head, and bend your knees for comfort and stability.
- Bend the elbow of the injured arm so that you fingers point toward the ceiling, then use your other hand to gently push the injured arm toward to the floor.
- Resist the push to feel the stretch, and focus on keeping your shoulder blades squeezed together as you move through the exercise.
- Hold the stretch for 30 seconds, then rest and repeat twice more.
- Hold a light weight (about 5 to 8 pounds), a hammer, or can of soup in the hand on your injured side.
- Stand up straight, keeping your elbow against the side of your body.
- Bring your palm up toward your shoulder, bending the elbow but keeping it in the same place. Pause, and then slowly return to the starting position.
- Complete 8 to 12 repetitions.
- Rest, and then complete another set. If this exercise is too easy, try upping your weight.
MultiCare Medical | Bicep Tendinopathy or Tendinitis Treatment Omaha & Papillon Nebraska
Your Physical Rehabilitation plays a crucial role in your recovery from any injury, illness, surgery, or disease that affects your musculoskeletal system. An individualized rehabilitation program at MultiCare Medical Group helps relieve pain, promote healing, and restores strength, motion, and balance. If you have any questions about rehabilitation, please call their office in Papillion, Nebraska at 402-505-7989, or schedule an appointment online for a rehab assessment.