1 0 obj Classic Long Head of Biceps Tendinopathy. 4 0 obj Since Hamilton Orthopaedics, Spine and Sports Medicine was founded by Dr. Ivan Gowan in 1984, the practice has grown exponentially to serve the ever growing demand in Central New York. They can also help you to correct any muscle imbalances or problems with your form to prevent recurrent injury. In general, most surgeons will recommend immobilization in a splint after surgery for a few weeks . It's a sign of overuse and your body is telling you that it needs a rest. These objectives may depend on ROM, strength, or activity. Other associated shoulder pathologies include: Primary LHB tendinitis represents about 5% of cases of proximal biceps pathology. stream The Most Common Causes Of Elbow Pain While Lifting. Biceps tendonitis describes a clinical condition of inflammatory tenosynovitis, most commonly affecting the tendinous portion of the LHB as it travels within the bicipital groove in the proximal humerus. Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy. Therapy Protocols | Orthopedics & Sports Medicine - BayCare PDF When is a conservative approach best for proximal biceps tendon In the early stages of the disease, the LHB tendon remains mobile in the bicipital groove. Characteristics of proximal biceps tendinitis include the following: In addition, a thorough history includes a detailed account of the patients occupational history and current status of employment, hand dominance, history of injury/trauma to the shoulder(s) and/or neck, and any relevant surgical history. Biceps stretch. 0 "f_}~;R0Dn`FAHqRg*oDoi|G? ~+Oi>ZMq0hgt;eQVy/|1|.FGQ+*Q{)vdOqd$=0B h2`d-b5q2|y+"yy=AWI[4C@`qA0m Q[/I- jq?"LHq If you have pain that starts as soon as you lift, or if it persists after you are done, it's time to shut that muscle down. Shoulder ROM exercises are encouraged. The median duration of follow-up was thirty-eight months. They will ask how your injury occurred, how it is affecting your work and recreational activities, and if you have had any treatment so far for your condition. The vast majority of cases are seen in association with the aforementioned shoulder pathologies. 8. Demographics. This tendon stretches along your biceps muscle from your elbow up to your shoulder. Bicep tendonitis elbow: a common injury in gym-goers - Sport Doctor London Care should be used, since ice placed directly on your skin may cause a frost burn. Surgical: If conservative management has not been successful then surgical management can be considered. %PDF-1.7 This electrical impulse may tickle a bit, but it should not cause pain. Thomas R. You can also try these exercises at home: Distal Biceps Tendonitis. That is usually the journal article where the information was first stated. Light strengthening exercises are started with light Theraband or 1-kg weights for elbow flexion, extension, forearm rotation and wrist flexion and extension. Youll notice a hard time twisting doorknobs or using tools like wrenches and screwdrivers. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Keep your arm straight. Treatment of Distal Biceps Tendinopathy Rest: The most important way to treat biceps tendinitis is to give your elbow a rest. They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. Working with a physical therapist can help you gain motion and strength, relieve pain, and return to your previous level of function and activity. Biceps tendinitis occurs when there's inflammation of the biceps tendon. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Atraumatic, insidious onset of anterior shoulder pain, Symptom exacerbation with overhead activities, Pain radiating down the anterior arm from the shoulder, Clicking or audible popping can be reported in the setting of proximal biceps instability, History or current sports, especially baseball, volleyball, and other overhead sports, History or current manual/physical laborer occupations, Superior labrum anterior-posterior lesions, Tendon sheath swelling (transverse view: for women 4.6, for men 5.5!mm;longitudinal view: for women 2.5, for men 2.8!mm, as adopted from Schmidt et al.). It is based in Green Bay, Wisconsin. Rubinger et al. Nonoperative treatment of distal biceps tendon ruptures - PubMed That way, you can be sure to start on the right treatment for your condition. PDF Distal biceps tendon repair early mobilization: Salyapongse - UW Health It commonly occurs in the dominant extremity of middle-aged men during an excessive eccentric tension as the arm is forced from a flexed . Various exercises may be included in your biceps tendonitis rehab program, including: Shoulder ROM exercises. Go to: Differential Diagnosis The diagnosis of the biceps tendon rupture sometimes is challenging. <> Kotara S. Singleton SB. <>/Metadata 640 0 R/ViewerPreferences 641 0 R>> Stuart Hershman, MD, is a board-certified spine surgeon. Supine scapula stabilization with 1kg weight. Simple treatments can reduce pain and improve mobility. If you have pain that starts as soon as you lift, or if it persists after you are done, its time to shut that muscle down. endobj x=ioCG)Q }NvdwyXIqlOlw_uP%R6,UbQ>|ZMjU>ckq?|vf~.qtq0_.z |~7{W w_ zSiH%YHhyNM%^N/sN|u@f$NE^)z'eLp[s;}yDf`@jArL"{1J?=Y2hHj#j3bA\8W?#|dot\qCFpzO bo$>gc{7XzFcoJ 8ylU'BYn3x=r=R@y/W0j-|4m.dV)gc+JghGS2znpT2zxBpC- 0nu|Y&AXqJdV(H|(iRyM@b9P{8g:9.87J Mr@}ar+W o+T*# ]kVxpg"xSP?Fq =!9pP=vGY(3~ Jt The biceps muscle has 2 tendons that attach it to the shoulder and travel the length of the upper arm and insert just below the elbow. D`^l(=/t Still, some therapists use it, and you may encounter it when being treated for your biceps tendonitis. Proximal bicep tendonitis: This is when there is inflammation. PNF D2 flexion and extension with tubing. ACL Reconstruction Rehabilitation Protocol, Bankart Repair or Anterior or Posterior Labral Repair, Medial Patellofemoral Ligament Repair/Reconstruction, Rotator Cuff Repair Rehabilitation Protocol. Main outcome measures of biceps tendinopathy are: Conservative: Initial treatment should consist of pain management and use of NSAIDs. endobj "B/_|`+BOxIQyD0r>}wKO_2{}_m_yg=^,wm~\,L) MM&"$^t)^k!Z_u This can confirm (or rule out) biceps tendonitis. Alphabet door / clockwise / counterclockwise circles with ball. The physical therapist must consider both the patient's subjective response to injury and the physiological mechanisms of tissue healing; both are essential in relation to a patients return to optimal performance. Exercises that work your biceps include curls, reverse curls, rowing, pull-ups, rope climb, and Olympic lifts. Since it is a new treatment, little research has been done regarding dry needling. This sheath provides lubrication to the tendon and allows it to glide and slide normally in the front of your upper arm. How to Treat Biceps Tendinitis If you think youve torn your biceps tendon, you should see a surgeon right away! Your email address will not be published. Overloading of the biceps tendon at your shoulder or elbow may cause biceps tendonitis. Most e-stim treatments, like transcutaneus electic neuromuscular stimilation (TENS) or neuromuscular electrical stimulation (NMES), last for about 10 to 20 minutes. In the setting of RC tears, 90% of cases demonstrated concomitant LHB tendinopathy, and 45% of cases had additional LHB instability[1], The pathophysiology of LHB tendinitis/tendinopathy begins with. In most cases Physiopedia articles are a secondary source and so should not be used as references. Biceps stretch: Stand facing a wall (about 6 inches, or 15 centimeters, away from the wall). Anatomic location. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The medication is typically an anti-infammtory liquid that is negatively charged. Physical Therapy: Therapists can use methods such as ultrasound, dry needling, TENS, IASTM, and more to help relieve pain. If your PT chooses to use e-stim for your biceps tendonitis, two to four small electrodes will be placed around your shoulder and upper arm, and electricity will be applied to the electrodes. He also holds a CF-L1 certificate and is a Certified BFR Specialist. These are done to determine your functional baseline and to guide treatment for your shoulder. Physical Therapy Guide to Biceps Tendon Rupture - Choose PT Available from: Park SS, Loebenberg ML, Rokito AS, Zuckerman JD. The biceps tendon, the tendon associated with the biceps muscle, is made up of 2 parts: the long head and the short head. But that takes a lot of work. Most cases can be treated successfully in about four to six weeks. Specific recommendations may be made by Dr. Cole to modify . The best way to diagnose biceps tendinopathy, is by comparative palpation of the biceps tendon along the intertubercular groove, or otherwise by doing a ultrasonography (extra-articulair). Rest: The most important way to treat biceps tendinitis is to give your elbow a rest. tendon. Ultrasound has been in use in PT clinics for many years. 2. Physical Therapy as a Conservative Treatment for a Proximal Biceps - US % Various exercises may be included in your biceps tendonitis rehab program, including: Some evidence indicates that performing eccentric exercise can help with tendinopathy and biceps tendon problems. Hamilton Orthopaedic | All Rights Reserved | Design by. Appointments: Monday - Friday 7:00am - 4:30pm, Business Office: Monday - Friday 8:00am - 4:30pm, Physical Therapy: Monday - Friday 7:00am - 5:00pm. %%EOF So be sure to check with your coach or trainer if you develop tendinitis of any kind. Although much less common, primary isolated cases are typically observed in young athletes participating in baseball, softball, volleyball, gymnastics, and/or swimming. Surgical procedures are performed in the ultra-modern surgical suites at Community Memorial Hospital in Hamilton. Immobilization in Splint with Elbow at 90 of flexion; Encourage digital , shoulder ROM; Elevation; Pain Control; Phase 1 (1 week to 6 weeks) Elbow immobilized in flexion-assisted Bledsoe brace with extension stop at 30 Gentle supervised passive ROM (active extension) from 30 . Distal biceps tendinopathy can also be known as distal biceps tendinosis or distal biceps tendinitis. Massage may also improve tissue mobility, allowing your shoulder and arm to move more freely. Supination/pronation through pain-free range. Gentle pulley while limiting elbow extension to -10 degrees. Of the thousands of people treated every year, many are children, adults and senior citizens who have chosen Hamilton Orthopaedics, Spine and Sports Medicine as the best place to give them the most advanced orthopaedic care. Initiate resisted wrist supination and pronation. It starts as two separate tendons that attach to the shoulder blade, just above the socket of your shoulder. stream The long head inserts at the top of the socket and the short head inserts adjacent to the socket on the coracoid process of the scapula. (2008) Essentials Of Strength Training And Conditioning. Notify your PT if you feel any pain so adjustments can be made. Raise your injured arm out to your side and place the thumb side of your hand against the wall (palm down). It is important to understand, that this inflammation has many different causes and is frequently accompanied by other shoulder pathologies such as: SLAP-lesions, rotator-cuff tears or instability. <>/Metadata 508 0 R/ViewerPreferences 509 0 R>> International Journal of Clinical Medicine. Distal Biceps Tendinopathy: Prevention and Treatment. Even kids try to show off their biceps when they want to prove how strong they are! If these simple steps are ineffective, other treatments such as cortisone injections, needle tenotomy, or PRP injections are possible. Distal Bicep Rupture | Bicep Tendon Tear Rehab (Without Surgery) While you're dealing with pain from an inflamed bicep tendon, fill an ice pack with ice and hold it against the area that's hurting for up to 20 minutes. The wand sends ultrasonic waves into your biceps tendon, heating the tissue. K(-fr Ball toss / trampoline chest pass 1kg weight. Distal Bicep Tendon Repair Protocol . *>c~%Is/c0.dLyP"Yydvl$8QZ ;1jD9H.oC~;,k^eMS={$I38Pm%.y{q![lt}Iwno6!VSnE&1$M> mO|@'$xJ!& IFzW8E=YoiX{IY,F2z2,$?rPO!Pp{-U[oNHM9wldb Structures causing primary and secondary impingement may be removed, and the biceps tendon may be repaired if necessary. Undergoing distal biceps tendon repair Exclusion Criteria: Revision Biceps tendon repair, Irrepairable tendon injury, Biceps repairs with biologic augmentation, Patients with concomitant neurovascular injury, Inability to tolerate BFR treatment, Unable to complete full course of physical therapy, Peripheral vascular disease, The short head of the biceps arises from the coracoid process of your shoulder blade. The pain may limit your shoulder motion and make performing normal work and recreational tasks difficult or impossible. By Brett Sears, PT Shoulder rotator cuff and scapular strengthening. Distal Biceps Tendon Reconstruction Rehab Protocol First 10-14 days Immobilization in Splint with Elbow at 90 of flexion Encourage digital , shoulder ROM Elevation Pain Control Phase I (2 weeks to 6 weeks) Elbow immobilized in flexion-assisted Bledsoe brace with extension stop at 30 Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy. Surgery should be considered if conservative measures fail after three months. Rehabilitation Program for Distal Biceps Repair Phase I (week 1) Posterior splint at 90 degrees of elbow flexion Wrist and hand gripping exercises Phase II (week 2-6) Elbow ROM brace o Week 2 @ 45-100 o Week 4 @ 30-115 o Week 6 @ 15-130 Shoulder exercises (rotator cuff) Scapular strengthening ~;.Js71$!wB3154FGAu% Your PT will apply strips of flexible fabric tape to your upper arm or shoulder. Baechle. The most common surgery for bursitis is a bursectomy, which removes the inflamed bursa to help relieve pain and promote healing. Surgical SLAP Repair. These may include a rotator cuff tear, AC joint arthritis, shoulder labrum injury, or cervical (neck) radiculopathy. Physical Therapist's Guide to Biceps Tendon Rupture Healing tissue must not be overstressed and a very slow heavy loading program should be undertaken. If you have pain in the front of your elbow when lifting, in the little hollow, it could be distal biceps tendinopathy. Best Exercises for Biceps Tendonitis - WebMD Copyright 2023. 172 0 obj <> endobj 2012;2012:405472. Rehabilitation of biceps tendon disorders in athletes. Long Head of the Biceps Tendon Pain: Differential Diagnosis and Treatment. Posterior splint at 90 degrees of elbow flexion. Biceps Stretch. Since the biceps tendon works to stabilize the front of your shoulder, it may become overworked if you have shoulder instability or rotator cuff tear. You may feel a bit of tingling underneath the medicated electrode, and some redness of your skin may occur after the iontophoresis is removed. They have great blood flow and can repair damage from exercise quickly. Applicability: Physician Practices Date Effective: 09/2013 Department: Rehabilitation Services Date Last Reviewed: 1/2021 . It is attached to the bones of the shoulder and elbow by tendons strong cords of fibrous tissue that attach muscles to bones. PDF Biceps Tendon Strengthening Exercises - Jaspal Ricky Singh, M.D Distal biceps tendonitis is an injury that results from overuse, and continuing to use an injured tendon can cause more damage. Biceps pulley: normal anatomy and associated lesions at MR arthrography. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. . Step 1: Allow your injured arm to hang at your side, then bend your elbow to a 90-degree. Restoring a pain free range of motion - Pain free range can be achieved with such activities as PROM, Active-Assisted Range of Motion (AAROM), and, Painful activities such as abduction and overhead activities should be avoided in the early stages of recovery as it can exacerbate symptoms. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Larson Sports and Orthopedics is a group made of a surgeon, athletic trainer, and experienced HIIT Coaches who specialize in orthopedic sports medicine including anatomy and physiology, injury prevention, and orthopedic surgery/rehabilitation. Bicep Tendon Tear - Physiotherapy Treatment Resisted IR with T-band. The tendon increases in diameter secondary to swelling and/or associated hemorrhage, further compromising the tendon as it becomes mechanically irritated in its confined space. %PDF-1.5 If you have pain in your upper arm or shoulder, you may have irritated your biceps tendon, a condition known as biceps tendonitis. The muscles and tendons of the rotator cuff hold the ball into the socket of the shoulder. Exercise has been shown to help improve ROM, strength, and functional mobility to your arm and shoulder. Dr. Gerhardt will make final determination). He started LSO to keep more people moving better, longer. Distal biceps tendon ruptures occur primarily in males and risk factors include smoking, corticosteroid use, and anabolic steroid use. 3 0 obj The biceps bends your elbow (flexion) and twists your forearm to turn your palm upward (supination). Plymouth Distal Biceps Repair Rehabilitation Protocol Phase 1. Supine scapula stabilization with no weight. But the biceps is a pretty important one. PDF Rehabilitation Protocol for Distal Biceps Tendon Repair Add Eccentrics: Eccentric exercise actually lengthens your muscles and decreases the risk of tendinitis. endobj The biceps tendon is one of the anchor points of the biceps muscle, which is important for bending the elbow and rotating the wrist. Your physical therapist may also have you perform a home exercise program that you do independently. Heat can also be used to decrease pain and improve tissue mobility. Read our, Physical Therapy Evaluation for Biceps Tendonitis, Physical Therapy Treatment for Biceps Tendonitis, Therapeutic Ultrasound in Physical Therapy, Physical Therapy for a Pectoralis Major Tear, KT Tape for Rotator Cuff and Shoulder Injuries, At-Home Exercises and Physical Therapy for Calcific Tendonitis, Causes of Shoulder Pain and Treatment Options, First Steps to Help Treat a Frozen Shoulder, Exercises to Improve Stability After a Shoulder Labrum Tear, Causes of Elbow Pain and Treatment Options, transcutaneus electic neuromuscular stimilation (TENS), neuromuscular electrical stimulation (NMES), Treatment of individuals with chronic bicipital tendinopathy using dry needling, eccentric-concentric exercise and stretching; a case series, Comparison of the Effects of Kinesio Taping to Local Injection of Methyl Prednisolone in Treating Brachial Biceps Tendonitis, Tenderness to touch in the front of your upper arm and shoulder. Biceps tendonitis describes a clinical condition of inflammatory tenosynovitis, most commonly affecting the tendinous portion of the LHB as it travels within the bicipital groove in the proximal humerus. ruptures tend to occur in the dominant elbow (86%) of men (93%) in their 40s. A distal biceps rupture occurs when the tendon attaching the biceps muscle to the elbow is torn from the bone. 2009; 39(2): 55-70. In addition, the sheath of the biceps tendon is a direct extension of the synovial lining of the glenohumeral joint. Long head of the biceps pathology combined with rotator cuff tears. This thickening of the ligament may cause abnormal rubbing on the tendon, leading to inflammation and irritation. It is not only athletes who benefit from the considerable skill and experience assembled here. Distal Biceps Tendon Repair Protocol Phase I ( 0-7 days post-op): Posterior splint at 90 degrees of elbow flexion. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. If you have pain in the front of your shoulder, you may have biceps tendonitis. Eccentrics are also able to promote healing of tendons and so I recommend sprinkling them throughout your regular workout routine. v"#1F2=aqTK-.J |-[Hx\ cpZj0+5+ajV2ecYS4h1SNrBdj? To serve as a guide to physical therapy following your surgery, this section contains rehabilitation protocols specific to your procedure. The diagnostic criteria for biceps tendinopathy were defined as meeting at least one of the following: All involved with the musculoskeletal US examination reached a consensus on these diagnostic criteria for the purpose of avoiding operator-dependent misdiagnosis.[2]. stream LHB tendon instability/dislocation (seen in association with subscapularis injuries/tears). Study Design: Case Study Objective: To describe the use of conservative treatment of a proximal long head of the biceps (LHB) tendon rupture for a patient preferring to forego surgery.. Background: The patient was a 49 year old male who presented with pain and weakness in the left shoulder, and a bulge in anterior, left brachium. And a key to that is some great looking biceps! Surgical treatment options . In advanced, end-stage conditions, the LHB tendon can eventually rupture at its origin near the superior glenoid tubercle, or as it exits the bicipital groove near its musculotendinous junction. When a direct current that is also negatively charged is applied to the medicine, it repels it, driving the drug into your tendon. Forearm twists help keep your arm flexible and help your tendon glide smoothly along the biceps muscle. Our doctors also perform surgeries at APEX Surgical Center. 1 0 obj IJSPT February 2012 vol7 issue 6 pg:663-671. Biceps tenodesis has traditionally been performed through the deltopectoral interval to visualize the retracted tendon distally in the groove. He supports weight training and high-intensity exercise throughout the lifespan. Mobilize: Chronic excess tension in your muscles from weight training can lead to damage over time. Biz C, Vinanti GB, Rossato A, Arnaldi E, Aldegheri R. Longo UG, Loppini M, Marineo G, Khan WS, Maffulli N, Denaro V. Nho SJ, Strauss EJ, Lenart BA, Provencher MT, Mazzocca AD, Verma NN, Romeo AA. In effect, the tendon becomes pathologically anchored in the groove, further exacerbating the potential points of traction and overall increasing shear forces experienced by the LHB tendon along its course. Our orthopedic surgeons have trained and practice at the most advanced orthopedic facilities and have years of experience. Tendonitis occurs most commonly in the long head of the biceps tendon. These may include: If you suspect you have biceps tendonitis, you should visit your healthcare provider right away to get a diagnosis. <> Distal Biceps Avulsion - Shoulder & Elbow - Orthobullets Your PT will also ask about your medical history and may review any medication that you are taking. Physical therapy initially focusing on unloading followed by reloading the effected tendon (see Tendinopathy rehab page for full details). BY lH& %>!"N5KsU&.ad,, D c$.eOO DS@ T" 2 0 obj PMID: 30997282 PMCID: PMC6449020 Tendinopathy of the biceps can be painless early on. If any exercise causes pain to increase, you should stop performing it and check in with your PT. Final visits are usually at 12 weeks. There are several muscles that help with both of these. Can start unrestricted strengthening as pain permits. The tape is used to decrease pain and spasm or to facilitate proper muscle function. Distal Bicep Tendon Rehabilitation Exercises - Health | NoahStrength.com [7] In low-functioning or medically complicated patients, conservative measures should always be pursued initially.[10]. Biceps Tenodesis Rehab Protocol - Houston, TX & Baytown, TX: David Notify your therapist if you feel discomfort during ice use in the PT clinic. 3 weeks post-op 30-115 5 weeks post-op 15-130 During ultrasound treatment, you should feel nothing except for mild warming around the ultrasound head. Your first appointment with a physical therapist (PT) for biceps tendonitis is called an initial evaluation. Author: Ryan Preszler Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. Supersedes: N/A: Or . <> Rehabilitation Protocol: Distal Biceps Tendon Repair - Accelerated Protocol; Rehabilitation Protocol and Post-op Instructions: Distal Biceps Tendon Repair - Moderate Protocol; Postoperative Extensor Mechanism Repair (Quad/Patella ORIF/Patellar Tendon Repair or Reconstruction) Physical Therapy Protocol The brace itself will be used for passive range of motion.Biceps Curl Hold a light weight (about 5 to 8 pounds), a . 10. Apply ice to the injury for 10-20 minutes, 3 times a day, for the first 3 days. 43 Tenotomy is the . complete distal biceps avulsion. Treatment of individuals with chronic bicipital tendinopathy using dry needling, eccentric-concentric exercise and stretching; a case series. Your practitioner may order diagnostic tests like magnetic resonance imaging (MRI) to view the soft tissue structures around your shoulder. 191 0 obj <>/Filter/FlateDecode/ID[<96B5A7559837E940A76D1930163689E3>]/Index[172 28]/Info 171 0 R/Length 96/Prev 212290/Root 173 0 R/Size 200/Type/XRef/W[1 3 1]>>stream It can also help improve circulation to the tendon and help facilitate healing. Icing can also be effective. The biceps muscle has two tendons at the shoulder. Exercise for biceps tendonitis should be challenging, but not painful. Other more invasive treatments for persistent biceps tendonitis may include cortisone injections, platelet rich plasma injections, or surgery. 2018;:1-11. doi:10.1080/09593985.2018.1488023, Zeinali A, Rahimdel A, Shahidzadeh A, Shahidzadeh A, Mellat A. Basically any action where you are pulling something toward you with your arms works the biceps. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. 3 0 obj %PDF-1.7 Each of these muscles starts out as tendons near the shoulder . Our doctors also perform some procedures at UHS Chenango Memorial Hospital as well. When the tendon is subjected to repetitive stresses, it can become irritated, swollen, and painful. Although ultrasound has been used for many years in PT, many research studies have found that it fails to offer significant benefits when compared to other treatments, such as active exercise. The biceps also play a very important role in rotating your forearm during activities such as turning a screwdriver or doorknob. As the pathophysiology escalates, there is an ensuing LHB sheath thickening, fibrosis, and vascular compromise. Thank you, {{form.email}}, for signing up. Biceps/Triceps tendon injuries. Biceps tendonitis may be difficult to diagnose, as other conditions may present as anterior shoulder pain. Other measures like bracing or physical therapy can help decrease inflammation. Begin active elbow flexion and supination at 6 weeks post-op. Anti-inflammatories: Ibuprofen or turmeric can help relieve the pain as well. Biceps Tendinitis: Exercises - Alberta PDF Rehabilitation Guidelines for Biceps Tenodesis