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Biceps Tendinitis

by Cathy Richey and Mark Lamendola

You may have heard this referred to as "biceps tendonitis," and while that is the logical spelling it is not the correct spelling. Many medical terms entered the lexicon from British usage, and this is one of them.

Biceps tendinitis is an inflammation of the biceps tendon. This tendon connects the biceps muscle to the shoulder. The painful spot is usually in the groove where the arm meets the shoulder. If you have even moderate inflammation, you can produce the pain by flexing your elbow at 90 and trying to turn your hand palm up (called supination) against resistance.

Biceps and tendons

The biceps muscle is a two-part muscle in the front area of the upper arm. This muscle helps stabilize the large bone in the upper arm (the humerus) in the shoulder socket. It also helps to accelerate and decelerate the arm during overhead activities, such as throwing a ball.

The biceps tendons keep the biceps muscle attached to the shoulder at one end, and the elbow at the other end.

Tendons are strong cord-like structures that connect each end of the biceps muscle to bones. At one end of the biceps muscle, tendons connect the biceps to the shoulder in two places. At the other end of the muscle, tendons connect the biceps muscle to the smaller bone (radius) in the lower arm.

Causes and risk factors

Injuries to the biceps tendons are often caused by repetitive overhead activity. Overuse, aging, and stress can cause the tendon to deteriorate, even if there is no inflammation present.

The overuse of the arm and shoulder often causes injury to the biceps tendon. Weight-lifters and tennis players whose activity involves repetitive arm flexing (like biceps curls) are often affected by biceps tendinitis.

But you don't have to be a hyper-athlete to become afflicted with biceps tendinitis. It afflicts people who engage heavily in such seemingly innocuous activities such as writing or typing. A nervous habit, such as rubbing thumb and forefinger together, can also bring it on. Incorrect posture at work or home or poor stretching or conditioning before exercise or playing sports also increases a person's risk.

So, don't rule out the condition just because you think you "don't overdo it." It's important to identify and correct the condition. A biceps tendinitis condition that initially began with a mild pain in the joint can turn into a severe and crippling biceps injury.

Anyone can get biceps tendinitis, but it is more common in adults, especially those over 40. As tendons age, they tolerate less stress, are less elastic, and are easier to injure.

 

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Biceps tendinitis symptoms

If you have the symptoms below, you probably have biceps tendinitis. Do not wait for it to go away. Do not self-medicate. Seek medical attention. These symptoms may indicate a more serious problem, though biceps tendinitis is serious enough.

  • Pain when the arm is overhead or bent .
  • Localized tenderness as the tendon passes over the groove in the upper arm bone.
  • Occasionally, a snapping (or clicking) sound or sensation in the shoulder area.
  • Thickness, swelling, and redness in the area over the tendon.
  • Pain or discomfort inside elbow while writing.
  • Noticeable weakness in any motion involving the affected arm.

If any one of these additional symptoms is also be present, alert your physician and make the earliest possible appointment:

  • Numbness in the fingers.
  • Profound weakness in any motion involving the affected arm.
  • Tingling in the elbow.
  • Pain in the neck or chest.
  • Unusual coloration in the fingernails.
  • Coldness in the fingers.
  • Any unusual bulge under the skin.
  • Excess thirst.
  • Cramps.

How long will the effects last?

The length of recovery depends on many factors such as your age, health, and history of injury.

In the case of previous injury, recovery time depends on the severity of the injury. You may recover from a mild injury may recover within a few weeks. You may need twice that long or even longer to recover from a serious injury.

Stop doing the activities that cause pain until the tendon has healed. If you continue doing activities that cause the tendon pain, your symptoms will return and it will take longer to recover.  Or, worse, you will cause permanent damage that even surgery might not fix.

Some serious strains of the biceps may involve tearing of the attachment of the tendon inside the shoulder joint. These injuries usually have persistent pain and weakness, and may take longer to heal.

Treatment and Rehabilitation:

Your number one concern is getting back to full strength as soon as possible so that you can return to training. That is why appropriate rehabilitation is extremely important. The most common rehabilitation for biceps tendinitis often includes the following:

  • Rest, avoid activity during the acute phase.
  • Apply ice or a cold pack to the injury for 15 to 20 minutes, 4 times a day for several days to keep swelling down. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
  • Take ibuprofen to help reduce inflammation and pain.
  • When the acute pain is gone, start gentle stretching exercises. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times.
  • Begin strengthening exercises for your biceps, shoulder, and arm muscles.
  • Gradually return to training or your sport. Begin arm motions of your sport or activity. [Source: www.sportsmedicine.upmc.com].

The major objectives of rehabilitation from biceps tendinitis are to improve the elasticity of the biceps tendon and to gradually increase pain-free range of motion.

You want to return you to your sport or activity as soon as is safely possible, not before. If you return too soon, you may worsen your injury and this can lead to permanent damage.

Everyone recovers from injury at a different rate. Whether to return to your activity is determined by how soon your biceps tendon area recovers, not by how many days or weeks it has been since your injury occurred.

You may safely return to your sport or activity when you have full range of motion in the injured arm compared to the uninjured arm, and full strength of the injured arm compared to the uninjured arm. Not before.

Reducing atrophy

During the period when you must rest the affected arm, exercise the other arm. This will invoke the sympathetic training response, stimulating the unexercised arm to retain muscle mass. If you can "go through the motions" without pain (and not using any weights whatsoever), it is also helpful to "train" the injured arm to retain the brain-mapping that is essential to athletic performance.

Also, maintain the hormonal environment. Men will do curls until they can't do them anymore, thinking this builds muscle. It doesn't. Many guys work their arms, wanting "beach muscles," but neglect to work their core. Then they wonder why their arms don't grow. Women tend not to be so vain, but usually have the same problem of not working the core.

Assume there are two twins (same genes) named Al and Bob.

  • Al does intense front squats twice a month (optimal recovery window for that workout) and lifts no other weights.
  • Bob does a biceps curls workout every 96 hours (optimal recovery window for that workout) and lifts no other weights.

At the end of three months, who will have bigger arms? If you guess Bob, you guessed wrong. Al has a superior hormonal profile, simply because those squats cause the body to respond with maximum testosterone output while the curls cause very little elevation of testosterone.

If you have biceps tendinitis and aren't doing squats, then take three months off your arm workout and just do squats twice a month. You will be very happy with the results, and your tendons will heal.

Prevention

You can best prevent a biceps injury by doing a proper warm-up and stretching exercises for your arms and shoulders before your activity.

Additional ways to avoid another episode of biceps tendinitis is to avoid the activity that caused it. For the serious athlete, frequent breaks from the activity causing pain should become routine. It's wise to reduce or stop the activity at first sign of pain and to ice the biceps and shoulder following each training session.

You can help prevent biceps tendinitis by following these simple recommendations:

  • Rest your body regularly by stopping to stretch.
  • Increase the frequency and intensity of exercise gradually.
  • Apply ice when necessary.

     

Benefits from stretching include

  • Increased physical efficiency and performance.
  • Decreased risk of injury.
  • Increased blood supply and nutrients to joint structures.
  • Increased coordination.
  • Improved muscular balance and better posture.
  • Reduced stress.
  • Enhanced enjoyment.


Increasing the intake of antioxidant-rich foods and lowering intake of animal fats has been found to reduce inflammation. See the nutrition articles elsewhere on this site. Please note that the normal American diet is guaranteed to cause health problems. Switching to a sensible diet takes very little effort, improves how much enjoyment you can get from your meals, and will eliminate a long list of health problems that sensible eaters just don't get.

Hydrotherapies, such as whirlpool baths are enjoyable, soothing, help relax the surrounding muscles, and aid in the healing process.

If given enough time, tendons will strengthen to meet the demands placed on them. That's what proper training achieves. Tendons grow slowly because of their poor blood supply, so adequate time is required for good conditioning. Doing your workouts with intensity will increase your vascularity and permanently increase the blood supply to those tendons.

 

 

 

About Cathy (one of the authors): Cathy and her Doberman Trooper conduct research into all kinds of topics and produce articles like the one you see here. To contact Cathy, write to thecathyfactor@yahoo.com. Get the facts from Cathy, and let the Cathy Factor give you an edge.

 

 

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