The pain may limit your shoulder motion and make performing normal work and recreational tasks difficult or impossible.
it’s possible for you to do PT in an outpatient setting, at home, or both.
What Is Bicep Tendonitis?
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There are several possible causes ofbicep tendonitis.
It is usually resulting from overloading and overusing the biceps tendon.
This often happens in repetitive overhead activities, such as racquet sports or baseball throwing.
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Age-related changes are another cause of biceps tendonitis.
This thickening of the ligament may cause abnormal rubbing on the tendon, leading to inflammation and irritation.
Shoulder androtator cuff injuriescan also contribute to biceps tendonitis.
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The initial injury and inflammation of the biceps tendon is called tendonitis.
Long-term biceps tendon problems are called biceps tendinopathy.
Anatomy of the Biceps
Yourbiceps musclesare located in the front of your upper arms.
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The short head of the biceps arises from the coracoid process of your shoulder blade.
The biceps muscle travels down your upper arm and inserts on the radial tuberosity of your forearm.
The primary function of your biceps is elbow flexion.
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This is why overloading of the biceps tendon at your shoulder or elbow may cause biceps tendonitis.
Symptoms of Biceps Tendonitis
There are many symptoms of biceps tendonitis.
Biceps tendonitis may be difficult to diagnose, as other conditions may present as anterior shoulder pain.
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Your physical therapist will work with you on a specific exercise regimen to treat your biceps tendonitis.
Physical Therapy Treatment for Biceps Tendonitis
There are many different treatments and modalities for biceps tendonitis.
Physical therapy is the main treatment for biceps tendonitis.
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Here are several exercises your physical therapist may work on with you.
Generally, you will want to do around 10 repetitions of biceps curls.
Focus on form and don’t rely on momentum to get you through your repetitions.
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Biceps Stretch
There are several ways to stretch your biceps.
Stretching your biceps can help improve your range of motion.
A common bicep stretch is the standing bicep stretch.
It can also help stretch your chest and shoulders.
Hold this stretch for up to a minute before releasing, and repeat up to three times.
Be careful not to overstretch your bicep, especially if it is injured.
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Shoulder Flexion
Shoulder flexion helps with your vertical range of motion.
Do this exercise for 10 repetitions several times throughout the day.
If you feel pain, stop and ask your physical therapist for modifications.
They may modify the exercise or switch you to a different shoulder flexion exercise.
Repeat this exercise 15 times or as instructed by your physical therapist.
It helps you to maintain the full motion of your shoulder joint.
Do this exercise for up to 15 repetitions or as directed by your physical therapist.
The following is one example of a shoulder external rotation stretch.
Forearm Twist
Forearm twists help with the flexibility of the arm.
Hold this exercise for five seconds and repeat it 10 times, or as instructed by your physical therapist.
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Shoulder Circle Crossover
This exercise helps with shoulder mobility in biceps tendonitis.
However, other treatments may help aid healing and can often be used in conjunction with targeted exercises.
Moves To Avoid
Limiting movements involving reaching and lifting is essential until your symptoms improve.
Massage
Your physical therapist may performvarious massage techniquesfor your biceps tendonitis.
Cross-friction massage may be done to stimulate collagen formation around your injured tendon.
This can help decrease pain and improve localized circulation.
Massage can also improve tissue mobility, allowing your shoulder and arm to move more freely.
Kinesiology Tape
Some physical therapists use a treatment technique called kinesiology taping, also known asK-tape.
Your PT will apply strips of flexible fabric tape to your upper arm or shoulder.
The tape decreases pain and spasms and facilitates proper muscle function.
Anecdotally, some people report improved symptoms and function with the tape, but more research is needed.
Heat can also decrease pain and improve tissue mobility.
Notify your PT if you get too warm during a heat treatment.
Ice
Ice may be used in the treatment of biceps tendonitis.
Ice decreases blood flow and can be used to control localized pain, swelling, and inflammation.
Your PT mayapply iceat the end of your therapy session to keep inflammation to a minimum.
Care should be used, since ice placed directly on your skin may cause a frost burn.
Notify your therapist if you feel discomfort during ice use in the PT clinic.
Ultrasound
Ultrasound has been used in PT clinics for many years.
The wand sends ultrasonic waves into your biceps tendon, heating the tissue.
This heat increases blood flow and cellular activity in the area.
Duringultrasound treatment, you should feel nothing except for mild warming around the ultrasound head.
A burning sensation may be felt if ultrasound is not applied properly.
Notify your PT if you feel any pain so adjustments can be made.
Although ultrasound has been used for many years in PT, exercise tends to be more effective.
While your therapist may utilize ultrasound, they will likely use it in combination with various exercises.
Electrical Stimulation
Electrical stimulationcan help treat biceps tendonitis or tendinopathy.
This electrical impulse may tickle a bit, but it should not cause pain.
Since it is a newer treatment, more research on its effectiveness is needed.
The medication is typically an anti-inflammatory liquid that is negatively charged.
Iontophoresis is usually applied for 10 to 20 minutes and should be painless.
How Long Should Treatment Take?
Most cases of biceps tendonitis take about four to six weeks to heal.
Your condition may take a bit longer if it is severe.
Talk with your PT about how long your specific condition is expected to last.
Other more invasive treatments for persistent biceps tendonitis may includecortisone injections,platelet rich plasma injections, or surgery.
Summary
If you have pain in the front of your shoulder, you may have biceps tendonitis.
This condition can make using your arm for normal work and recreational activities difficult.
American Academy of Orthopaedic Surgeons.Biceps tendinitis.
UpToDate.Patient education: biceps tendinitis or tendinopathy (Beyond the Basics).
