When treating a Biceps Tendinopathy, we always start by looking at the triceps.
Pathology of the Long Head Biceps (LHB) is implicated in a range of shoulder problems from frozen shoulder syndrome to rotator cuff tendinopathy. It is almost always present in frozen shoulder syndrome to some extent.
Biceps means literally two-heads. The short head provides about 85% of the power and the long head about 15%. Damage can occur from trauma or falls on outstretched hands, and it is commonly tweaked by simple actions such as reaching behind the body to the back seat of the car.
Anatomically the biceps tendon (long head) is vulnerable to injury in certain mechanical positions; especially where it runs under its retaining transverse ligament. The LHB tendon has its own special groove running up the humerus bone called the ‘bicipital groove’.
Biceps Brachii - Common Trigger Point Sites
The LHB tendon is unique in that it inserts inside the capsule of the joint to attach directly to the socket bone (lower glenoid fossa). This means, inflammation that starts lower down the tendon can track upwards directly into the ball and socket joint causing havoc; as is the case in frozen shoulder syndrome.
Triceps Brachii - Common Trigger Point Sites
The joint capsule is exquisitely well nourished with small nerve fibers and can then become a source of shoulder pain. An inflamed LHB can also lead to bursitis which can sometimes be seen as a small soft mobile lump in the region of the transverse ligament.
It's worth noting that the LHB often acts (incorrectly) as a stabilizer in a range of shoulder problems to prevent external rotation (elbow bent and kept into the waist and hand moving outwards). This is a weak function of the LHB, this action is usually performed by the rotator cuff, but when the cuff is compromised the LHB kicks-in.
Trigger Point Therapy
When treating a biceps tendinopathy, we often start by treating the triceps. See the video above for an explanation and demonstration of NAT trigger point treatment protocols.
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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