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Rehabilitation
for biceps tendinitis
Alternative exercises
Rehabilitation after surgery
How long will the effects of the injury last?
When can I return to my sport or activity?
Read more about biceps
tendinitis
Rehabilitation
for biceps tendinitis
As an athlete, your number one concern is getting back to full strength
as soon as possible so that you can return to training and competition.
That is why appropriate rehabilitation is extremely important. The most
common rehabilitation for biceps tendinitis often includes the following:
- Rest
Avoid activity during the acute phase.
- Ice
Apply ice or a cold pack to the injury for 15 to 20 minutes, 4 times
a day for several days to keep swelling down. Wrap the ice or cold pack
in a towel. Do not apply the ice directly to your skin.
- Medication
Take ibuprofen to help reduce inflammation and pain.
- Stretching
When the acute pain is gone, start gentle stretching exercises as recommended
by your doctor. Stay within pain limits. Hold each stretch for about
10 seconds and repeat 6 times.
- Strengthening
Begin strengthening exercises for your biceps, shoulder, and arm muscles
as recommended by your doctor.
- Gradual Return
to Your Sport
Begin arm motions of your sport or activity as recommended by your doctor.
(For example: passing a football,
throwing a baseball, tennis
strokes, golf
swings).
- Surgery
Arthroscopic surgery may be necessary if the pain results from shoulder
instability or from pressure on the tendon from the shoulder bones.
The major objectives
of rehabilitation from biceps tendinitis are to improve the elasticity
of the biceps tendon and to gradually increase pain-free range of motion.
The following exercises should be performed once or twice daily:
- Saws
Reach out and place the unaffected side hand on a corner of a table.
Bend at the waist. Flex the injured side arm at the elbow and pull the
injured side arm backward and upward as if sawing wood. Slowly bring
the shoulder blades as close together as pain will permit. Slowly bring
the injured side arm down to its beginning position. Repeat this sequence
10 times, at least three times daily.
- Pendulum swings
Stand with the hand of the unaffected arm resting on the corner of a
table and supporting some of the body weight. Slightly bend the knee
on the unaffected side and extend the other leg sideways. Allow the
injured arm to hang loosely over the unaffected side foot. By shifting
the body weight, cause the relaxed injured arm to swing in circles to
the fullest extent possible as limited by pain. Perform 25 swings in
a clockwise direction. Allow the injured arm to cease swinging. Perform
25 swings of the injured arm in a counterclockwise direction. Repeat
this sequence at least three times daily.
- Shoulder rotation
Stand in a doorway with affected side arm bent at the elbow and the
palm of the hand against the doorframe. Turn the body away from the
injured side hand until a stretching sensation is experience in the
injured shoulder. Hold this position for 10 seconds. Return to the starting
position. Relax for 10 seconds. Repeat this sequence 10 times at least
3 times a day.
- Shoulder flexion
Stand erect close to a wall. With the palm of the injured side arm turned
so as to face you, slowly slide the forearm and then the upper arm up
the wall by moving closer to the wall. Slide the arm upward to the point
of initial significant pain. Hold this position for 10 seconds. Return
to the starting position and relax for 10 seconds. Repeat this sequence
10 times, at least 3 times daily.
- Towel stretch
Roll a towel lengthwise. While standing erect, dangle the rolled towel
down the back, holding it with the unaffected side hand. Reach behind
the back with the hand of the injured side and grasp the rolled towel.
Gently pull upward on the towel, raising the injured side arm until
first significant pain in the injured shoulder appears. Hold this position
for 10 seconds. Relax the arms while maintaining the grasp on the rolled
towel for 10 seconds. Repeat this sequence 10 times at least three times
daily.
- Flexed elbow
pull
Bend and raise the injured side elbow to shoulder height. Grasp the
injured side elbow with the uninjured side hand. Gently pull the injured
side elbow toward the opposite shoulder until limited by first significant
pain. Hold this position for 10 seconds. Relax for 10 seconds. Repeat
this sequence 10 times at least three times daily.
- Bicep stretch
Stand erect with arms raised to shoulder height and palms up. Press
arms backward until stretch is felt. Hold this position for three to
five seconds, then relax for 3 to 5 seconds. Perform this exercise 10
times. The bicep as well as the muscles of the shoulder and upper chest
are stretched by this exercise.
- Tricep stretch
Stand erect with feet at about shoulder width. Raise injured arm at
the shoulder with elbow bent and place the forearm behind the head.
Grasp the injured elbow with opposite hand and draw it toward the center
of the body until stretch is felt. Hold this position for 3 to 5 seconds,
then relax for 3 to 5 seconds. Perform this exercise 10 times.
- Bicep curls
Stand with arms fully extended at sides while grasping 2- to 5-pound
weights in each hand, held palm forward. Flex the arms at the elbow
to approximately 100 degrees, or to the point of pain, whichever comes
first. Hold this position for 5 to 10 seconds. Return to the start position.
Rest for 5 seconds. Repeat this exercise 10 times. You can increase
the weight as pain allows and strength develops.
- Triceps curls
Stand with elbows directed upward over the shoulders and with arms relaxed.
Extend arms at the elbow so that the hands proceed upward to the point
of pain. Hold this position for five seconds. Return to the starting
position and relax for five seconds. Perform this sequence 10 times,
3 times daily. As pain permits, add weight by using hand-held dumbbells.
- Chest raises
Lie on belly with hands extended along sides of the body. Raise the
upper chest from the floor to the point of pain and hold this position
for 5 seconds. Return to the start position and relax for 10 seconds.
Repeat this sequence 10 times, 3 times daily.
Alternative exercises
During the period when normal training should be avoided, alternative
exercises may be used. These activities should not require any actions
that create or intensify pain at the site of injury. They include:
Rehabilitation
after surgery
Your biceps tendinitis may require arthroscopic surgery to properly anchor
the biceps tendon. Keep in mind that the soft tissue needs time to heal
before exercise can begin.
A physical therapy
program usually begins with range-of-motion and resistive exercises, then
incorporates power, aerobic and muscular endurance, flexibility, and coordination
drills.
Finally, patients
develop speed and agility through sport-specific exercise routines.
The ultimate goal
of surgery is to provide dynamic stability while maintaining full range
of motion, so that athletes can return to competitive or recreational
sports. Progress is assessed by the patient's perception of how stable
the biceps/shoulder feels and by comparing the strength and stability
of the injured and uninjured arms.
How long will the
effects of my injury last?
With proper rehabilitation, a first occurrence of biceps tendinitis diagnosed
and treated in its early stages usually lasts two weeks. If the injury
has recurred several times, or if surgery is necessary, full recovery
may take as long as two months.
When can I return
to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity
as soon as is safely possible. If you return too soon you may worsen your
injury, which could lead to permanent damage. Everyone recovers from injury
at a different rate. Return to your activity is determined by how soon
your biceps tendon area recovers, not by how many days or weeks it has
been since your injury occurred.
You may safely return
to your sport or activity when:
- You have full range
of motion in the injured arm compared to the uninjured arm.
- You have full strength
of the injured arm compared to the uninjured arm.
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