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Trigger Point Release - Biceps/Pec Minor Muscle Strain

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Trigger Point Release - Biceps Muscle Strain / Tendinitis


Bicipital Tendinitis

Bicipital tendinitis results from irritation and inflammation to the biceps brachii tendon, which lies on the front of the shoulder and allows elbow flexion and supination of the forearm.

Overuse can lead to inflammation and is a common affliction in golfers, weightlifters, rowers and those engaged in throwing sports.

Irritation of the tendon of the long head of biceps occurs as it moves up and down in the intertubercular (bicipital) groove of the humerus. Inflammation can be to the tendon itself or to the tendon sheath or paratenons.

The musculo-tendinous junction of biceps brachii is highly susceptible to injuries brought on by overuse, particularly following repetitive lifting activities.

Cause of Injury

Poor technique, particularly in weightlifting. Sudden increase in duration or intensity of training. Shoulder impingement syndrome.

Signs and Symptoms

Pain over the bicipital groove when the tendon is passively stretched and during resisted supination and elbow flexion. Pain and tenderness along the tendon length. Stiffness following exercise.

Trigger Points

Trigger points in the biceps are commonly involved in this injury. Where the injury has occurred as a result of trauma or overuse, additional triggers may become active as part of the body's natural "protect and defend" mechanism. 

These triggers and their affect on delivering pain signals and reducing range of movement are sometimes referred to as "holding patterns".

Complications if Left Unattended

Bicipital tendinitis, left without care and treatment, generally worsens as the biceps brachii tendon becomes increasingly irritated and inflamed. Movement and the ability to perform athletically without pain will be further hampered. Exercising without adequate healing and rehabilitation can lead to tearing of the tendon and tendon degeneration over time.

Immediate Treatment

RICER regimen to relieve painful inflammation. Anti-inflammatory and analgesic medication. Then heat to promote blood flow and healing.

Rehabilitation and Prevention

The condition is self-limiting given rest and minimal medical attention. Following full recovery, exercises directed at improving flexibility, proprioception and strength may be undertaken. Thorough warm-up and stretching exercises and a steady athletic regimen that avoids sudden, unprepared increases in activity can help avoid this injury, as can attention to proper sports technique.

Long-Term Prognosis

A full return to athletic activity may generally be expected given adequate time for tendon recovery and reduction of inflammation. However, the injury frequently recurs. Surgery is generally not required. Corticosteroid injections are sometimes used to reduce pain, though they must be applied cautiously as they increase the risk of tendon rupture.



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