Biceps tendinitis is a bewildering condition that has seemingly stumped some of the greatest healthcare providers on the planet. What causes it? How do we fix it?
Simply put, biceps tendinitis is an inflammation of the long head of the proximal biceps tendon. It presents as a sharp pain in the front of your shoulder and is typically made worse by raising your arm out in front with a palm up hand position. This is often confused as a shoulder impingement, which typically presents on the TOP of the shoulder joint.
By definition, tendinitis has to have a duration of less than 6 weeks. Most chronic biceps tendon pain persists longer than that and needs to be classified as a biceps tendinosis. The difference between a tendinitis and a tendinosis is quite simple. The “itis” is acutely inflamed. The “osis” is chronically degenerated.
Biceps tendinosis/tendinitis is caused due to protective tension. Rotator cuff muscles will develop adhesion (even without the presence of rotator cuff pain), causing an instability to the joint. As a way to manage the instability, your brain will enforce more tone on the biceps. Eventually, this irritates the tendon, causing inflammation and degeneration.
By utilizing a couple of exercises at home, it is possible to help your biceps tendinopathy! First off, measure your shoulder function by doing this test. If you notice that you have a deficit in your range of motion, try this and this for 4-6 weeks, remeasure, and see if there's improvement. If there is, keep at the exercises and your pain should decrease. If not, please seek professional help.
It's also important to note that weakness plays a big role in shoulder function. If you cannot do a single push-up, your shoulders need more strength. Utilize this video to improve strength. You can also work simple dumbbell overhead presses in order to improve strength. Use this video for reference.
If we know what CAUSES biceps tendinitis, we know how to fix it. By removing adhesion in the rotator cuff and joint capsule, we can restore proper stability to the shoulder joint. This will alleviate tension on the biceps tendon, thus reducing pain.
We confirm our suspicions of rotator cuff adhesion by measuring the range of motion of the shoulder joint and then palpating the tissues. Upon removing the adhesion, the range of motion should instantly improve. Within days of the first treatment, symptomatic relief should be felt.
It’s important to note that with very chronic cases of biceps tendinosis, it is useful to directly work the front of the shoulder. This will not only help with the pain in the front of the shoulder, but it will help to reorganize the tissue and promote blood flow to the area.
After removing adhesion and reducing symptoms by about 80%, it’s time to load the area responsibly. My favorite shoulder exercises are an off-the-knee shoulder external rotator, one arm upright rows, and one arm dumbbell shoulder presses. All exercises must be performed with a slower eccentric portion relative to the concentric.
The combination of an excellent diagnosis, adhesion removal, local work to the biceps tendon, and exercises will get 95% of biceps tendon patients better.
At Wildcard Spine and Sport, we specialize in fixing pain that’s lasted longer than six months, even if you’ve seen two or more providers. We are the only practitioners in the five boroughs certified to diagnose and remove adhesion. Click the button below or call the office today at 917-908-0055.