What is it?
The biceps brachii muscle consists of two components, the long and the short head. The muscle originates from the front of the shoulder and attaches down at the upper forearm. The tendon aspect of the biceps is at its origin and its insertion. In between the tendinous components the more bulky muscle belly connects to either side. All of which are part of the biceps muscle.
The role of the biceps is to bend the elbow, as well as twisting the palm upwards. â€œTendinopathyâ€ refers to an injury of any type to the tendon. This commonly consists of tendinitis; inflammation to the tendon or tendinosis; microtears in the connective tissue. Tendon injuries are often as a result of overuse, however this is not always the case.
How does it happen?
The role of a tendon is to absorb energy, while transmitting forces to the muscle. Therefore, it is common for tendinopathies to occur over a sustained period of time. Often as a result in change of activity or loading. As the injury is often slow-developing, symptoms will present after tissue damage has already occurred. Therefore, it is critical to address the issue immediately following onset of symptoms, in order to prevent the condition becoming chronic.
Sports specific tendinopathy can be due to activities which include throwing or racquet sports involving heavy use of the biceps. However, those not involved in sports can sustain the injury. Activities of daily living that involve lifting the arm in a repetitive manor increase the risk of biceps tendinopathy. Older adults are more susceptible to this type of injury due to decreased collagen and elastin components of the tendon.
What are the symptoms?
Pain is the most notable symptom that patients experience. An aching pain at the end of day is typical as well as increased pain during movements the recruit the biceps such as lifting or overhead activities. The location of pain is typically at the origin of the tendon at the front of the shoulder and may travel down the arm. Sleeping on the affected arm may result in increased pain at night.
Altered biomechanics is often as a result of this condition. People will attempt to move in a way that offloads the biceps muscle. A common example of this is lifting the shoulder in order to recruit different muscles to help with the movement. Consequently, this leads to increased load and poor movement patterns that lead to secondary injury elsewhere on the body.
How can physiotherapy help?
Our role as your physiotherapist will be to assess the condition and develop an individualised management plan. With the aim at reducing your pain in order to get you back doing the activities you want to do. Throughout the detailed assessment, your physiotherapist will address any other issues that you present with. The management plan may include manual therapy, education and modification to activity levels, home exercise program to address biomechanical impairments. Physiotherapy will also refer for imaging or to other health professionals if necessary.