Bicep injuries & how to fix them | Part 2

April 9, 2020

Following on from our previous blog on bicep tendon injuries, we will be sharing with you the various signs and symptoms of a biceps tendon rupture, and what you should do if you suspect one. To cover the other end of the spectrum (an injured, but intact biceps), we will also be sharing some simple exercises to help kickstart the rehab process in the early stages.

Part 2 – The Bicep tendon rupture, how to identify it, and what to do next.

A ruptured bicep tendon tends to be rather obvious, and not something you will be in doubt over. These are the main things you will likely experience.

The painful pop!

  • Accompanied by a sharp pain as the tendon tears or detaches itself from the bone.
  • Usually when you are doing movements that places significant load on the biceps (see part 1 of our bicep injury blog).

The Popeye Sign

  • An abnormally high peak when you are flexing your elbow.
  • Difference in the height between both biceps (a legitimate excuse to check your guns out in the mirror!). See Strongman/Powerlifter/Bodybuilder Larry Wheels checking his arm after rupturing his proximal head of biceps whilst lifting the Atlas Stones.

The Daily Struggle

  • Difficulty with simple day to day tasks such as turning a key or lifting a pot.

* Although these are the common signs and symptoms, do remember that everyone is different, and you might experience things differently. When in doubt, get yourself assessed by a qualified health professional! 

Strongman/Powerlifter/Bodybuilder checking his arm after rupturing his proximal head of biceps.

This sounds like me, what should I do?

Most bicep tendon ruptures will require surgical repair, and the outcomes are better the sooner this is performed. Thus, getting an assessment by an orthopaedic specialist should be the priority. Visit the nearest NHS minor injuries clinic to get yourself booked into the orthopaedic emergency clinic. In the meantime, put your arm in a sling, ice the area frequently, up to 20 minutes at a time, and don’t use the injured biceps.

If you have private health insurance (or self-paying), you can phone your provider to request for an urgent referral to a specialist in this field. ESP’s preferred orthopaedic consultant for surgical management of these injuries is Mr Andrew James Brooksbank, consulting out of Ross Hall in Glasgow.

What happens after surgery?

Following your surgery, you will be advised to follow a guided physiotherapy rehabilitation program. With an experienced surgeon, and a comprehensive physiotherapy program, most athletes can make a full recovery to competition within 9-12 months., and sometimes even quicker!

I’m pretty sure it’s not a rupture, what now?

Once we are sure there isn’t a rupture, we suggest using the POLICE guidelines which applies to both tendon and muscle injuries.

P – Protect

Protect the tendon from further injury. This means that you stop the movements that makes the pain worse, or even taping the bicep muscle and tendon to offload it temporarily. Forget the no pain, no gain, tough it out mentality, and give the biceps muscle/tendon a chance to settle down. You can expect things to calm down and start the repair response within 72 hours. 

OL – Optimal Loading

Once things have settled, you will want to start gradually loading the muscle/tendon. This is because complete rest or immobilization does not help injuries to heal quicker, and in fact, might slow down the recovery process. (Article link to police guidelines here)

A combination of stretches and/or light exercises might be helpful as well (see this in the next section below). Meanwhile, continue with your daily activities and use your arm as much as possible with minimal pain.

*Do not load the tendon if you suspect a rupture. Follow the instructions in the section discussing a biceps rupture!

I Ice

Ice the painful area for 10-20 minutes several times per day for the first few days. This is to help with pain and reduce inflammation. You can stop when the pain settles.                                                                                                                                                                                                                                                                                                                                                                                                                   

C – Compression

Compression devices such as tubigrips, neoprene sleeves or compression cuffs can help support the muscle, and minimise inflammation. This is most helpful if there is swelling in the area.

E – Elevation

In the first few days of the injury, try to keep the arm elevated above the heart. This will help reduce the number of inflammatory cells flowing into the bicep muscle. Similarly, this is most helpful if there is swelling in the area.

How to start rehabilitating the bicep?

Here are some exercises you can try to load and gently stretch the injured area. Follow the exercise prescription advice in the description of each Instagram video.  

If your pain/symptoms are getting worse with these exercises, stop and consult a qualified health professional.

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𝐁𝐈𝐂𝐄𝐏𝐒 𝐒𝐄𝐑𝐈𝐄𝐒⁣ ⁣ 𝘉𝘪𝘤𝘦𝘱𝘴 𝘛𝘦𝘯𝘥𝘰𝘯 𝘗𝘢𝘪𝘯 – 𝘐𝘴𝘰𝘮𝘦𝘵𝘳𝘪𝘤 𝘏𝘰𝘭𝘥𝘴⁣ ⁣ If you lift a lot 🏋️‍♀️ you may begin to feel discomfort in the base of your elbow 💪🏻⁣ ⁣ If you’ve been curling, rowing, or pulling movements in the gym recently, it may well be indicative of a biceps tendinopathy, which is basically an overuse injury of the biceps tendon, where it inserts to the  bones of your forearm, just below the elbow joint.⁣ ⁣ A frustrating condition, but one that exercise tends to help quite a lot‼️⁣ ⁣ One exercise that your physiotherapist might ask you to perform is an isometric elbow contraction – that is a contraction where you don’t actually allow the joint to move.⁣ Isometric exercise has been shown to ease pain in certain tendon injuries and can be useful way to begin rehabilitation in the presence of a biceps tendonitis.⁣ ⁣ Holding a contraction against a band or the bottom of table can be a great way to begin your rehab, and/or a great tool for you to prime the tendon for training – potentially allowing you to maintain your workload in the gym.⁣ ⁣ Give it a try and let us know how you go! 😀⁣ ⁣ ➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖⁣⁣⁣ 📲 Book by phone on 01324 227 370⠀⁣⁣⁣ 🌏 Book online at espphysio.com⠀⁣⁣⁣ ⁣⁣⁣ Proud to support 🌐 ⁣⁣⁣ @stevenraymma ⁣⁣⁣ @dannyhenrymma ⁣⁣⁣ @tomstoltman⁣⁣⁣ @luke.stoltman⁣ @the_problem155⁣ ⁣⁣⁣ Affiliates 🌐 ⁣⁣⁣ @pulseroll – £10 off using code ESPPhysio10 ⁣⁣⁣ @stirlingcounty⁣ ➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖⁣⁣⁣ ⁣⁣⁣ #physiotherapy #physio #physioglasgow #physiostirling #physioedinburgh #physiofalkirk #espphysio #stirlingcountyrugbyfootballclub #biceppain #biceptendonitis #biceprupture #longheadbiceps #mediannerveentraptment #mediannerve #physioadvice #mobility #exercises #flexibility #mobility #romwod #strength #espphysio #physioblog #strongman #powerlifting #crossfit

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⁣⁣ ⁣⁣ Exercise 3 in this weeks video series is a great long head of bicep stretch 💪🏻⁣⁣ ⁣⁣ Use a resistance band and gently distract the arm back by stepping forward with the arm outstretched.⁣⁣ ⁣⁣ You should feel the stretch run down the front of the bicep and depending on how you angle the body you can really target the front of the chest and shoulder 🎯⁣⁣ ⁣⁣ We would recommend performing for 30-60 seconds x 3 sets daily or a few times per week. ⁣⁣ ⁣⁣ As always if this movement makes your pain worse then stop ✋🏻 and drop us a DM for help 🆘⁣⁣ ⁣⁣ Tag someone with bicep pain 💪🏻⁣ ➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖⁣⁣⁣⁣ 📲 Book by phone on 01324 227 370⠀⁣⁣⁣⁣ 🌏 Book online at espphysio.com⠀⁣⁣⁣⁣ ⁣⁣⁣⁣ Proud to support 🌐 ⁣⁣⁣⁣ @stevenraymma ⁣⁣⁣⁣ @dannyhenrymma ⁣⁣⁣⁣ @tomstoltman⁣⁣⁣⁣ @luke.stoltman⁣⁣ @the_problem155⁣⁣ ⁣⁣⁣⁣ Affiliates 🌐 ⁣⁣⁣⁣ @pulseroll – £10 off using code ESPPhysio10 ⁣⁣⁣⁣ @stirlingcounty⁣⁣ ➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖⁣⁣⁣⁣ ⁣⁣⁣⁣ #physiotherapy #physio #physioglasgow #physiostirling #physioedinburgh #physiofalkirk #espphysio #stirlingcountyrugbyfootballclub #biceps #biceppain #biceprupture #biceptendinopathy #biceptendinitis #physioadvice #mobilityexercises #flexibility #mobility #romwod #strength #strongman #blog

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𝐁𝐈𝐂𝐄𝐏𝐒 𝐒𝐄𝐑𝐈𝐄𝐒⁣ ⁣ 𝘉𝘪𝘤𝘦𝘱𝘴 𝘛𝘦𝘯𝘥𝘰𝘯 𝘗𝘢𝘪𝘯 – 𝘉𝘢𝘯𝘥𝘦𝘥 𝘓𝘰𝘯𝘨 𝘏𝘦𝘢𝘥 𝘉𝘪𝘤𝘦𝘱 𝘊𝘶𝘳𝘭𝘴⁣ ⁣ Biceps injuries can be really tough to rehabilitate, particularly when we’re talking about long head of biceps problems, such as tendonitis. Since the long head of biceps is particularly important during overhead, and externally rotated movements, late-stage rehab should spend some time developing this capacity.⁣ ⁣ This exercise is a great version of a banded bicep curl – lift the elbow, externally rotate the arm, and perform a series of slow, controlled curls.⁣ ⁣ Sets are usually done for control and conditioning, so 3×15 can be a great place to start.⁣ ⁣ Give it a shot and tell us how you go!⁣ ⁣ Tag anyone with a sore bicep 😀⁣ ⁣ ➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖⁣⁣⁣ 📲 Book by phone on 01324 227 370⠀⁣⁣⁣ 🌏 Book online at espphysio.com⠀⁣⁣⁣ ⁣⁣⁣ Proud to support 🌐 ⁣⁣⁣ @stevenraymma ⁣⁣⁣ @dannyhenrymma ⁣⁣⁣ @tomstoltman⁣⁣⁣ @luke.stoltman⁣ @the_problem155⁣ ⁣⁣⁣ Affiliates 🌐 ⁣⁣⁣ @pulseroll – £10 off using code ESPPhysio10 ⁣⁣⁣ @stirlingcounty⁣ ➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖⁣⁣⁣ ⁣⁣⁣ #physiotherapy #physio #physioglasgow #physiostirling #physioedinburgh #physiofalkirk #espphysio #stirlingcountyrugbyfootballclub #biceppain #biceptendonitis #biceprupture #longheadbiceps #physioadvice #mobility #exercises #flexibility #mobility #romwod #strength #espphysio #physioblog #strongman #powerlifting #crossfit

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Should I see someone about this?

Gradual and progressive loading is the key to fixing bicep injuries. At ESP, our qualified physiotherapists perform a thorough assessment to assess the full extent of the injury. We can help manage your pain with various soft tissue treatments, and modalities. Following which, a personalised exercise program will be designed to gradually load the injured area, and address the various causes of your injury to prevent it from happening again.

With that, we have come to the end of our blog series on bicep injuries. If you would like to be assessed by one of our physiotherapists, you can book yourself in for an appointment here! Alternatively, call us at 01324 227 370 or drop us an email at info@espphysio.comand we will get you sorted!

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