What is Tendonitis of the Bicep?
By Rachel Consolazio PTA
Understanding Tendonitis of the Bicep
Tendinitis of the Bicep is acute pain and swelling at the distal long head of the bicep tendon. There are two heads of the bicep brachia, the long head and the short head. Additionally, The bicep brachia is innervated by the musculocutaneous nerve. This nerve originates from C5-C6 levels of the cervical spine. As a consequence, Biceps tendinitis of the long head is most commonly seen.
3 Types of Bicep Injuries
There are 3 types of injuries to the long head of the bicep at the shoulder.
- Tendonitis: Inflammation and thickening of the tendon
- Subluxation: Dislocation of the tendon from the bicipital groove
- Tendon Tear/Tears: Rupture of the long head of the bicep tendon
Common Causes of Bicep Tendonitis
Common causes of bicep tendinitis are normal wear and tear over time, repetitive overhead activities from work, home and sports.
Sports that Increase the Risk of Bicep Injuries
- Soft ball
- Martial arts
Work Activities That Increase the Risk of Bicep Injuries
- Heavy overhead lifting
- Repetitive overhead lifting
- Lifting and carrying objects away from your body
- Overhead repetitive tool use
Other causes of bicep tendinitis can be from falls, sudden over excursions and contusions from trauma. Additionally, injury to the long head of the biceps can result from impingement by the acromion process. As a consequence, resulting in weak rotator cuff muscles, muscle tightness, capsular tightness and poor posture of scapula thoracic joint/spine.
Supraspinatus rotator cuff tears are commonly seen with long head of the biceps tendinitis, tears and ruptures. Also, superior labrum tears are always associated with long head of the bicep’s tears and ruptures. Additionally, it is important to note that the long head of the biceps helps stabilize the anterior shoulder during sports such as: throwing activities, tennis and swimming.
Treatment for Bicep Tendonitis
- Rest/A/AAROM and oral anti inflammatory medications
- Spinal/ hips
- Sacral alignment/stabilization
- Dry needling
- Graston (instrument assisted soft tissue mobilization)
- BFR blood flow restriction training
- Kinesiology taping (KT tape or rock tape)
- Modalities (ultra sound, electrical stimulation, laser therapy, and micro current point stimulation)
- Cortisone injections
Physical Therapy Treatments
- Specified JOI sport medicine directed exercises for return to a particular sport
- Rotator cuff strengthening exercises
- Scapula stabilization exercises
- Core strengthening exercises
- Postural retraining exercises
Typical recovery period for biceps tendinitis is 6-8 weeks. Surgery is needed when there is a tear, rupture, subluxation or dislocation of the long head of the biceps.
Bicep Tendonitis Exercises
Stand facing a wall. Then, raise your arm with the injury out to your side and place the thumb side of your hand against the wall palm down. Keep your arm straight. Last, rotate your body in the opposite direction of the raised arm until you feel a stretch in your biceps. Do 3 times with 10 seconds hold.
Stand and hold a 3-5 pound dumbbell in your hand. Then, bend your elbow and bring your hand palm up toward your shoulder. Lastly, slowly straighten your arm and return to your starting position. Do 3 sets of 10 reps.
Resisted Shoulder Internal Rotation:
Stand sideways next to a door with your injuries arm closest to the door. Tie a knot in the end of a theraband and shut the knot in the door at the waist level. Hold the other end of the theraband with the hand of your injured arm. Bend the elbow of your injured arm 90 degrees. Keeping your elbow at your side, rotate your forearm across your body and the then slowly back to the starting position. Do 3 sets of 10 reps.
Resisted Shoulder External Rotation:
First, stand sideways next to a door with your injuries arm farthest from the door. Second, tie a knot in the end of a theraband and shut the knot in the door at the waist level. Additionally, hold the other end of the theraband with the hand of your injured arm. Rest hand of your injuries arm across your stomach. Keeping your elbow at your side, rotate your forearm outward and away from your waist. Lastly, slowly return back to the starting position. Do 3 sets of 10 reps
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