Bicep Muscle Injuries
The bicep, or biceps brachii, is the large muscle on the front of the upper arm. The muscle itself has two tendon attachments at the shoulder and a large, flat attachment into the elbow. As such, its action is to bend the elbow, turn the palm up (supinate), and lift the arm up. There are many injuries that can occur at the bicep, but the most common ones at City Physio are biceps tear and biceps tendonitis.
Bicep tears and ruptures are more common in individuals between 40 and 60 yrs who already have a history of shoulder problems. Most tears in the tendons themselves are generally ‘overuse tears,’ and can be the result of poor postures wearing down and fraying the tendons over long periods of time.
Younger individuals can also tear or rupture their bicep, but this is more likely with a fall on an outstretched arm or heavy weightlifting. It is more common in the dominant arm.
Bicep ruptures or muscle tears are more common with age, repeated overhead exercise, smoking, steroid use and in men.
Biceps tear or rupture will present as a sudden sharp pain in the shoulder or elbow with swelling, weakness, and bruising in the following days. Depending on the extent of the tear there may be an obvious bunching of the muscle, or divot, where the fibres have torn. These injuries almost always require a scan and surgical review to determine if they are suitable for conservative rehabilitation, or need a surgical repair of the muscle.
There are 2 kinds of biceps tendonitis that can cause pain at the shoulder and elbow levels where the tendon crosses the joints. In both cases the inflammation of the tendon is caused by an overload. Put simply, the tendon has been injured at a rate higher than it is able to heal, and thus it has become inflamed, swollen and sore.
Proximal biceps tendonitis is probably one of the most common forms of shoulder pain that we see at City Physio. At the shoulder level, poor scapular stability, posture and excessive overhead work can contribute to proximal biceps tendonitis by overloading the structures at the front of the shoulder. This overtime causes excessive loading of the rotator cuff and biceps tendon, causing shoulder impingement syndromes.
Distal biceps tendonitis occurs at the elbow level. Similarly to proximal biceps tendonitis, it often occurs due to an overload of the tendon at the elbow where it joins into the forearm. This is most commonly caused by rapid increase in weightlifting requirements of the arm, poor shoulder stability, and even prolonged positions such as carrying children on that arm.
Treatment of tendonitis is always multi-faceted. The most important part of the treatment is to identify where the overload came from. If it was a large overhead painting job that has now be completed, then this is now less important, but if the overload has come from prolonged desk use with a poorly set up mouse or keyboard, or a modified tennis serve, then this is most important to address. No amount of physiotherapy can unload a tennis swing with excessive top spin, with multiple heavy trainings, and games per week!
City Physio & Sports Injury Centre has been providing musculoskeletal physiotherapy in the MLC Centre for over 30 years. Our team are expertly trained in providing detailed full-body assessments and delivering personalised treatment for musculoskeletal conditions, sports injuries, headaches, neck and back pain. Book your appointment online here today.