| The biceps muscle is located in the front of the | | | | unaffected side and extend the other leg sideways. |
| upper arm and is attached to the shoulder and lower | | | | Allow the injured arm to hang loosely over the |
| arm bone. The muscle helps to control movements | | | | unaffected side foot. By shifting the body weight, |
| of the lower arm and is involved in throwing | | | | cause the relaxed injured arm to swing in circles to |
| movements like those associated with football or | | | | the fullest extent possible as limited by pain. Perform |
| baseball. Tendons attach the biceps muscle to points | | | | 25 swings in a clockwise direction. Allow the injured |
| in the shoulder and forearm. If the tendons are | | | | arm to cease swinging. Perform 25 swings of the |
| overused and become inflamed or irritated, the | | | | injured arm in a counterclockwise direction. Repeat |
| condition is called tendonitis. | | | | this sequence at least three times daily. |
| Repetitive overhead movement and activities like | | | | # Shoulder rotation |
| throwing a baseball or swinging a tennis racquet are | | | | Stand in a doorway with affected side arm bent at |
| common causes of biceps tendonitis. Symptoms may | | | | the elbow and the palm of the hand against the |
| include: | | | | doorframe. Turn the body away from the injured |
| # pain when the arm is overhead or bent | | | | side hand until a stretching sensation is experience in |
| # localized tenderness as the tendon passes over | | | | the injured shoulder. Hold this position for 10 seconds. |
| the groove in the upper arm bone | | | | Return to the starting position. Relax for 10 seconds. |
| # occasional popping sound or feeling in the shoulder | | | | Repeat this sequence 10 times at least 3 times a |
| area | | | | day. |
| How can I prevent biceps tendonitis? | | | | # Shoulder flexion |
| The simplest way to avoid another episode of biceps | | | | Stand erect close to a wall. With the palm of the |
| tendonitis is to avoid the activity that caused it; of | | | | injured side arm turned so as to face you, slowly |
| course, this may be impossible for the serious athlete. | | | | slide the forearm and then the upper arm up the wall |
| For these people, frequent breaks from the | | | | by moving closer to the wall. Slide the arm upward to |
| causative activity should become routine. It's also | | | | the point of initial significant pain. Hold this position for |
| wise to reduce or stop the activity at first sign of | | | | 10 seconds. Return to the starting position and relax |
| pain and to ice the bicep and shoulder following each | | | | for 10 seconds. Repeat this sequence 10 times, at |
| training session or game. | | | | least 3 times daily. |
| You can help prevent biceps tendonitis by following | | | | # Towel stretch |
| these simple recommendations: | | | | Roll a towel lengthwise. While standing erect, dangle |
| # Rest your body regularly by stopping to stretch. | | | | the rolled towel down the back, holding it with the |
| # Increase the frequency and intensity of exercise | | | | unaffected side hand. Reach behind the back with |
| gradually. | | | | the hand of the injured side and grasp the rolled |
| # Apply ice when necessary. | | | | towel. Gently pull upward on the towel, raising the |
| Diagnosis | | | | injured side arm until first significant pain in the injured |
| To properly diagnose biceps, your physician will check | | | | shoulder appears. Hold this position for 10 seconds. |
| your shoulder for any tenderness or joint looseness. | | | | Relax the arms while maintaining the grasp on the |
| You may be asked to extend, raise, or rotate your | | | | rolled towel for 10 seconds. Repeat this sequence 10 |
| arm to determine any range-of-motion limits. If | | | | times at least three times daily. |
| necessary, your physician will order x-rays or a | | | | # Flexed elbow pull |
| magnetic resonance imaging (MRI) scan for a more | | | | Bend and raise the injured side elbow to shoulder |
| detailed look at the injury. | | | | height. Grasp the injured side elbow with the |
| Conservative treatment for biceps tendonitis can | | | | uninjured side hand. Gently pull the injured side elbow |
| include: | | | | toward the opposite shoulder until limited by first |
| # Rest | | | | significant pain. Hold this position for 10 seconds. Relax |
| Avoid activity during the acute phase. | | | | for 10 seconds. Repeat this sequence 10 times at |
| # Ice | | | | least three times daily. |
| Apply ice or a cold pack to the injury for 15 to 20 | | | | # Bicep stretch |
| minutes, 4 times a day for several days to keep | | | | Stand erect with arms raised to shoulder height and |
| swelling down. | | | | palms up. Press arms backward until stretch is felt. |
| # Medication | | | | Hold this position for three to five seconds, then |
| Take ibuprofen (Advil, Motrin) to help reduce | | | | relax for 3 to 5 seconds. Perform this exercise 10 |
| inflammation and pain. | | | | times. The bicep as well as the muscles of the |
| # Stretching | | | | shoulder and upper chest are stretched by this |
| When the acute pain is gone, start gentle stretching | | | | exercise. |
| exercises as recommended by your doctor. | | | | # Tricep stretch |
| # Strengthening | | | | Stand erect with feet at about shoulder width. Raise |
| Begin strengthening exercises for your biceps, | | | | injured arm at the shoulder with elbow bent and |
| shoulder, and arm muscles as recommended by your | | | | place the forearm behind the head. Grasp the injured |
| doctor. | | | | elbow with opposite hand and draw it toward the |
| If conservative measures are not effective, | | | | center of the body until stretch is felt. Hold this |
| arthroscopic surgery may be necessary. During | | | | position for 3 to 5 seconds, then relax for 3 to 5 |
| arthroscopic surgery, an orthopaedic surgeon makes | | | | seconds. Perform this exercise 10 times. |
| a few small incisions and inserts extremely small | | | | # Bicep curls |
| instruments to exam the tendons. If necessary, the | | | | Stand with arms fully extended at sides while |
| surgeon can then make any necessary repairs. | | | | grasping 2- to 5-pound weights in each hand, held |
| Improving Sports Performance | | | | palm forward. Flex the arms at the elbow to |
| The key to improving sports performance after | | | | approximately 100 degrees, or to the point of pain, |
| recovering from biceps tendonitis is a proper a | | | | whichever comes first. Hold this position for 5 to 10 |
| rehabilitation program, and adhering to some of those | | | | seconds. Return to the start position. Rest for 5 |
| same principles after the injury is gone. | | | | seconds. Repeat this exercise 10 times. You can |
| The single most important aspect of improving | | | | increase the weight as pain allows and strength |
| performance is stretching before and after you step | | | | develops. |
| onto the field, court, ice, or golf course. | | | | # Triceps curls |
| Benefits derived from stretching include: | | | | Stand with elbows directed upward over the |
| # increased physical efficiency and performance | | | | shoulders and with arms relaxed. Extend arms at the |
| # decreased risk of injury | | | | elbow so that the hands proceed upward to the |
| # increased blood supply and nutrients to joint | | | | point of pain. Hold this position for five seconds. |
| structures | | | | Return to the starting position and relax for five |
| # increased coordination | | | | seconds. Perform this sequence 10 times, 3 times |
| # improved muscular balance and postural awareness | | | | daily. As pain permits, add weight by using hand-held |
| # reduced stress | | | | dumbbells. |
| # enhanced enjoyment | | | | # Chest raises |
| REHABILITATION FOR BICEPS TENDONITIS | | | | Lie on belly with hands extended along sides of the |
| As an athlete, your number one concern is getting | | | | body. Raise the upper chest from the floor to the |
| back to full strength as soon as possible so that you | | | | point of pain and hold this position for 5 seconds. |
| can return to training and competition. That is why | | | | Return to the start position and relax for 10 seconds. |
| appropriate rehabilitation is extremely important. The | | | | Repeat this sequence 10 times, 3 times daily. |
| most common rehabilitation for biceps tendonitis | | | | Alternative exercises |
| often includes the following: | | | | During the period when normal training should be |
| # Rest | | | | avoided, alternative exercises may be used. These |
| Avoid activity during the acute phase. | | | | activities should not require any actions that create |
| # Ice | | | | or intensify pain at the site of injury. They include: |
| Apply ice or a cold pack to the injury for 15 to 20 | | | | # swimming (if pain allows) |
| minutes, 4 times a day for several days to keep | | | | # jogging |
| swelling down. Wrap the ice or cold pack in a towel. | | | | # stationary bicycle |
| Do not apply the ice directly to your skin. | | | | REHABILITATION AFTER SURGERY |
| # Medication | | | | Your biceps tendonitis may require arthroscopic |
| Take ibuprofen to help reduce inflammation and pain. | | | | surgery to properly anchor the biceps tendon. Keep |
| # Stretching | | | | in mind that the soft tissue needs time to heal |
| When the acute pain is gone, start gentle stretching | | | | before exercise can begin. |
| exercises as recommended by your doctor. Stay | | | | A physical therapy program usually begins with |
| within pain limits. Hold each stretch for about 10 | | | | range-of-motion and resistive exercises, then |
| seconds and repeat 6 times. | | | | incorporates power, aerobic and muscular endurance, |
| # Strengthening | | | | flexibility, and coordination drills. |
| Begin strengthening exercises for your biceps, | | | | Finally, patients develop speed and agility through |
| shoulder, and arm muscles as recommended by your | | | | sport-specific exercise routines. |
| doctor. | | | | The ultimate goal of surgery is to provide dynamic |
| # Gradual Return to Your Sport | | | | stability while maintaining full range of motion, so that |
| Begin arm motions of your sport or activity as | | | | athletes can return to competitive or recreational |
| recommended by your doctor. (For example: passing | | | | sports. Progress is assessed by the patient's |
| a football, throwing a baseball, tennis strokes, golf | | | | perception of how stable the biceps/shoulder feels |
| swings). | | | | and by comparing the strength and stability of the |
| # Surgery | | | | injured and uninjured arms. |
| Arthroscopic surgery may be necessary if the pain | | | | How long will the effects of my injury last? |
| results from shoulder instability or from pressure on | | | | With proper rehabilitation, a first occurrence of biceps |
| the tendon from the shoulder bones. | | | | tendonitis diagnosed and treated in its early stages |
| The major objectives of rehabilitation from biceps | | | | usually lasts two weeks. If the injury has recurred |
| tendonitis are to improve the elasticity of the biceps | | | | several times, or if surgery is necessary, full recovery |
| tendon and to gradually increase pain-free range of | | | | may take as long as two months. |
| motion. The following exercises should be performed | | | | When can I return to my sport or activity? |
| once or twice daily: | | | | The goal of rehabilitation is to return you to your |
| # Saws | | | | sport or activity as soon as is safely possible. If you |
| Reach out and place the unaffected side hand on a | | | | return too soon you may worsen your injury, which |
| corner of a table. Bend at the waist. Flex the injured | | | | could lead to permanent damage. Everyone recovers |
| side arm at the elbow and pull the injured side arm | | | | from injury at a different rate. Return to your |
| backward and upward as if sawing wood. Slowly | | | | activity is determined by how soon your biceps |
| bring the shoulder blades as close together as pain | | | | tendon area recovers, not by how many days or |
| will permit. Slowly bring the injured side arm down to | | | | weeks it has been since your injury occurred. |
| its beginning position. Repeat this sequence 10 times, | | | | You may safely return to your sport or activity |
| at least three times daily. | | | | when: |
| # Pendulum swings | | | | # You have full range of motion in the injured arm |
| Stand with the hand of the unaffected arm resting | | | | compared to the uninjured arm. |
| on the corner of a table and supporting some of the | | | | # You have full strength of the injured arm |
| body weight. Slightly bend the knee on the | | | | compared to the uninjured arm. |