There are four basic types of bicep tendon injuries.
- The first is known as tendinitis (acute)/tendinosis (chronic) which usually occurs or is brought about from overuse or in proper biomechanical wear.
- The second is bicep tendon dislocations.
- The third is the bicep tendon tear.
- Lastly is the bicep tendon impingement syndrome.
Biceps Anatomy & Movement
The bicep has two heads and runs from the area above the shoulder joint to the area below the elbow joint. It is a true two joint muscle. Many people are surprised to know that the bicep not only curls/flexes the elbow, but also is involved with elevation of the upper arm.
To properly use the bicep in a curl you must begin with your arms extended to the thigh. As you begin to raise the arms and curl the weight, begin to elevate the front upper arms so that the bar finally touches your forehead. Do not bend your forehead down to touch the bar; rather bring your arms forward and upward towards your head.
The short head of the bicep is also involved in supination of the wrist. This is observable with your arm outstretched forward with your thumb pointing up towards the ceiling, then rotate your thumb away from the midline of your body and return it to an upright position. You will see the bicep slightly contract as you perform this motion.
Tendinitis & Tendinosis
Tendinitis is a condition associated with overuse and is usually less than two weeks of duration. Using ice and some anti-inflammatories and rest will result in the body recovering from this type of injury.
The chronic form of the tendon irritation is best treated with light activity and heat to promote local circulation throughout the affected area. Most tendons respond very well to the use of local topical treatments designed to bring additional circulation to that area.
Using alfalfa in a tablet form has been a long-term "home remedy" to many athletes. Other treatments to the bicep may include electric stimulation, cross-frictional massage, ultrasound, and laser just to mention a few. Using NSAIDs (non-steroidal anti-inflammatory drugs) will result in additional damage to any chronic tendon problem. They do this by removing the sulfur necessary for the collagen formation associated with tendon repair.
Adhesions often play a role in the bicep tendon injuries. They can mimic bicep tendon injury by creating pain with any movement. Adhesions often times occur in muscles and can complicate any common type of tendon injury. Adhesions are usually removable with full range of motion exercises and in some cases deep tissue massage. Sometimes arthroscopic surgery is necessary to remove significant damage from the tendon surface.
Improper muscle strain and flexibility will produce imbalances associated with the shoulder joint and also with the bicep tendon. Basic muscle test performed by a licensed physician and/or physical therapists will often reveal this type of problem. These lead to abnormal biomechanical forces that result in tendinopathy.
Biceps Tendon Tears
Biceps tendon tears will often occur due to trauma or extremely heavy lifting. Many biceps have been torn off by individuals during deadlifts. Some of these conditions will require surgery and general medication to prevent infection.
The increase of various foods such as onions, garlic and other foods high in sulfur will aid in tendon tear prevention. Some individuals, who use excessive antibiotics prior to a tear, will result in weakening of the tissue. Fluoro quinolones such as Cipro, are commonly associated with tendon tears and should be avoided whenever possible.
Just simply remind the doctor that you are actively lifting weights and wish to avoid any type of antibiotic that may weaken your tendons. The effects of antibiotics on your tendons can last up to 6 months before any injury will occur. It is common to see this type of injury in men between the ages of 16 to 45 years of age.
Tendon Impingement Syndrome
Tendon impingement syndrome is often diagnosed when specific movement results in shoulder pain. Patients will often state that something feels "pinched" or "impinged" when the arm is being moved.
The most common tissues that can get pinched in the shoulder region are the biceps tendon and the supraspinatus tendon. When these tendons become pinched it begins subsequent inflammation and can even lead to fraying of the involved tissues.
Extreme conditions of pinched tendon can eventually lead to rupture of the involved anatomy. Some of the complete tears may result in the need for surgery; however, partial tears may only require rest and additional physical therapy.
Please see a physician anytime you have sharp pain, bruising, fever, rash, unexplained bleeding, disfiguration or simply just pain that last longer than a couple days. Any new injury should always be immediately assisted by using ice wrapped in a wet towel and placed on the affected area for approximately 10 minutes.
Remove the cold application after 10 minutes and keep the area elevated for approximately 20 to 30 minutes (or until the area has returned to normal body temperature). Repeat to steps 5 to 6 times a day. Do not apply heat to any new injury, since this will complicate the injury and result in double the amount of time necessary to completely heal.