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Biceps Tendinitis Physiotherapy
Biceps tendinitis is actually a quite common cause of
Biceps tendinitis often happens to individuals who
perform repetitive, overhead movements.
It also usually is a progressive condition ie develops over
time, with pain located at the front of the shoulder, and usually
worsens with continued aggravating activity/exercise.
When treating biceps
tendinitis, our senior physiotherapists and hand therapists
- work to determine the exact source of
the pain by assessing the entire shoulder
- prescribe a
program of activity modification, stretching, and strengthening to
resolve pain and return patients to their desired activities
What is Biceps Tendinitis?
Tendinitis is a condition in which inflammation progressively worsens and accumulates at a
tendon, causing pain.
The our biceps tendon, the tendon associated with the
biceps muscle, is made up of 2 parts (see picture):
- the long biceps head
- the short biceps head
The long head of the biceps is the one that is most commonly affected by tendinitis, as
the tendon from the muscle runs up the length of the arm and attaches to
the labrum (a rim of cartilage) and the shoulder blade in the shoulder
Biceps tendinitis happens when there is excessive, abnormal forces are applied
across the tendon, including
- tension (a pulling of the muscle and
- compression (pushing or pinching)
- shearing (rubbing).
the tendon is subjected to repetitive stresses, it can become irritated,
swollen, and painful.
There are many factors that may lead to biceps tendinitis, including:
- Activities requiring repetitive overhead movement of the arms, such
as placing dishes in a high cupboard or lifting boxes above the head.
- Rotator cuff injuries and tears
- Weakness in the rotator cuff and muscles of the upper back
- Shoulder joint hypermobility (looseness)
- Shoulder joint stiffness
- Shoulder joint muscle tightness
- Poor body mechanics (how a person controls their body when moving)
- An abrupt increase in an exercise routine (increasing exercise intensity/frequency too fast)
- Age-related body changes
- Other pathology within the shoulder joint
How Does Biceps tendinitis Feel like?
If you are experiencing biceps tendinitis, you may feel:
- Sharp pain in the front of your shoulder when you reach overhead, behind your back, or across your body
- Tenderness to touch at the front of your shoulder
- Pain that may radiate toward the neck or down the front of the arm
- Dull, achy pain at the front of the shoulder, especially following activity
- Weakness felt around the shoulder joint, usually experienced when lifting or carrying objects or reaching overhead
- A sensation of "catching" or "clicking" in the front of the shoulder with movement
- Pain when throwing a ball
- Difficulty with daily activities, such as reaching behind your back
to tuck in your shirt, or putting dishes away in an overhead cabinet
- Pain when resting that may become worse at night
How Is biceps tendinitis Diagnosed
When you first see our senior physiotherapist, they will
- review your medical history
- ask you to describe your shoulder
- perform a comprehensive physical exam of your shoulder
and upper body
They will assess different measures,
such as sensation, motion, strength, and flexibility, and may ask you
to briefly perform the activities that cause your pain.
They will likely touch various areas on your
shoulder to see which seem to be most consistently painful. Other nearby
areas, such as your neck and upper back, also will be examined to
determine whether they might be contributing to your shoulder pain.
Imaging techniques, such as an X-ray or MRI, are typically not needed
to diagnose biceps tendinitis.
However, in the event that our senior physiotherapists suspects there are other conditions possibly present in your shoulder,
you may be referred to an orthopedic surgeon for further investigation.
how our senior physiotherapist can help
Once biceps tendinitis has been diagnosed, our senior physiotherapist s
will work with you to develop an individualized plan tailored to your
specific shoulder condition and your goals. There are many physiotherapy treatments that have been shown to be very effective in treating biceps tendinitis
Your treatment may include:
Range-of-motion exercises. Often, abnormal motion of
the shoulder joint may contribute to biceps tendinitis. We will assess your shoulder motion compared to the expected
normal motion and to the motion of your other shoulder. We will guide you through exercises to improve your shoulder’s
range of motion.
Muscle strengthening exercises. The muscles of the
shoulder and upper back work together to allow for normal, coordinated
upper-body motion. Based on the way the shoulder joint is designed (a
ball-and-socket joint, like a golf ball on a golf tee), there are many
directions in which the shoulder may move. Therefore, balanced strength
of all the upper-body muscles is crucial to make sure the shoulder joint
is protected and is moving efficiently. We will
choose exercises to safely strengthen the muscles around your shoulder
without causing more pain.
Manual therapy. We are trained in
manual (hands-on) therapy. We will gently move and
mobilize your shoulder joint and surrounding muscles as needed to
improve their motion, flexibility, and strength. These techniques can
target areas that are difficult to treat on your own.
Pain management. We may
recommend therapeutic modalities, such as cold therapy and heat therapy, to aid in pain
management, and reduce the need for medication, including opioids.
Functional training. Improper movements can, over
time, cause pain in the body. Our senior physiotherapists are experts in
assessing movement quality and in training people to function at their
best. We will point out and correct any movements
that could be causing you trouble, so you can maintain a pain-free
shoulder throughout your daily activities. Often, the strategies learned
through specific education from our senior physiotherapist will allow you
to avoid reversing the positive effects of your physiotherapy, and
help make sure that your improvements last.
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At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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