When a muscle is overstretched, asked to contract hard against a sudden load, or overused, injury can occur to the muscle, the spot where the tendon attaches to the muscle or the tendon itself. Small tears in the muscle fibers or the fibers of the tendon are called a strain. A biceps tendon strain could involve either the tendon that connects the biceps to the radial tuberosity in the forearm and helps bend the elbow and turn the palm face up or the tendon that connects the muscle to the shoulder and helps raise the arm.

Tendons are inelastic meaning they do not stretch easily. They transmit forces between the muscles and the bones and are generally very strong but can be injured. Tendon injuries can happen when a sudden high load is placed across the tendon or if it is overstretched or overworked. Weight lifters or athletes, for example, can strain their biceps tendon suddenly or after a period of overuse such as when they ramp up a training cycle too quickly. The biceps tendon can also be strained when trying to lift or catch something heavy or if you fall on an outstretched arm.

WHAT DOES A BICEPS TENDON STRAIN FEEL LIKE?

Symptoms of a biceps tendon strain can be felt along the length of the biceps tendon, between the belly of the muscle and where it attaches at the shoulder or forearm. It may also be felt where the tendon attaches to the bone. A mild strain can cause pain along the tendon when the biceps muscle is contracted or lengthened. For example, you may notice pain when you lift something or reach your arm overhead.

If the strain is moderate in severity, you may also notice some localized stiffness, tenderness, and swelling. You may also observe that the biceps muscle feels weaker than usual. If the strain is severe, the muscle belly or tendon can tear completely causing the range of motion in the elbow or shoulder to be either significantly reduced because of guarding or excessive because the torn muscle or tendon is no longer limiting it.

It is important to note that while the biceps is the most prominent muscle in the upper arm, its primary role is to support other muscles in moving the elbow, forearm and shoulder. This means that while a biceps strain may cause pain or discomfort when moving those joints, you should not lose the ability to move them altogether.

If you decide to work with a physical therapist to help correct your strained bicep tendon issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPISTS CAN HELP YOU RECOVER

While mild biceps tendon strains often recover on their own within a few weeks, you may choose to see a physical therapist to address a more severe strain or if the symptoms of a mild strain interfere with your activities. The goals and interventions for rehabilitation of a biceps tendon strain can be broken down into three stages:

Early/acute phase (first 5-7 days):

• Protect the tendon to allow healing to begin
• Use bracing, taping or immobilization as needed to minimize painful motions and excess strain on the tendon
• Consider ice, ultrasound or other modalities to manage inflammation and promote healing
• Passive range of motion that is pain-free may be used to prevent stiffness, maintain range of motion and reduce pain
• Exercising nearby but uninjured areas of the body is helpful

Middle/subacute phase (7-21 days or so after injury)

• Introduce active range of motion
• Wean off bracing, taping, etc.
• Begin submaximal exercise to lightly load the muscle and promote good fiber alignment in the tendon
• Begin very light stretching as needed
• Apply gentle soft tissue mobilization to promote healing, reduce pain and mobilize edema

Late/chronic phase (21 days to many months)

• Begin loading the muscle more intensively while monitoring for signs of acute regression including lasting soreness or inflammation
• Increase the load on resistance training
• Increase stretching and mobility
• Incorporate more dynamic upper body exercises
• Begin exercises to improve tendon stiffness to help prevent future injuries
• Perform work and sport-specific drills to prepare for return to activity

DON’T GO IT ALONE

As you can see, recovering well from a biceps tendon strain requires knowledge of the healing process. Whether you are experiencing a strain for the first time or are stuck in a cycle of healing and re-injury, physical therapy is a fantastic resource to help you recover. There is no need to go it alone. The physical therapists at Evolve are here to educate you on the healing process, get you back to your favorite activities and teach you how to prevent re-injury in the future. Call to schedule an evaluation today.