2014

For my own reference.


Contributing factors to the development of bicep tendonitis
There are several factors which can predispose patients to developing this condition. These need to be assessed and corrected with direction from a physiotherapist. Some of these factors include:
-joint stiffness (particularly the shoulder or thoracic spine)
-muscle tightness (particularly the biceps or pectorals)
-inappropriate or excessive training or activity
-inadequate recovery periods from sport or activity
-inadequate warm up
-muscle weakness (particularly the scapula stabilisers and rotator cuff)
-poor posture
-shoulder instability
-abnormal biomechanics (e.g. poor throwing technique or stroke technique in swimming)
-Past history of shoulder injury
-bony anomalies of the acromion or AC joint

Physiotherapy for bicep tendonitis
Physiotherapy treatment for patients with this condition is vital to hasten the healing process, ensure an optimal outcome and reduce the likelihood of recurrence. Treatment may comprise:
-soft tissue massage
-electrotherapy (e.g. ultrasound)
-stretches
-dry needling
-joint mobilization
-ice or heat treatment
-the use of a sling
-exercises to improve strength, flexibility, shoulder blade stability and posture
-education
-postural correction
-postural taping
-technique correction
-anti-inflammatory advice
-training and activity modification advice
-a gradual return to activity program

Exercises for bicep tendonitis
The following exercises are commonly prescribed to patients with this condition. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 2 - 3 times daily and only provided they do not cause or increase symptoms.
Your physiotherapist can advise when it is appropriate to begin the initial exercises and eventually progress to the intermediate, advanced and other exercises. As a general rule, addition of exercises or progression to more advanced exercises should take place provided there is no increase in symptoms.

Initial Exercises
Shoulder Blade Squeezes
Begin this exercise standing or sitting with your back straight. Your chin should be tucked in slightly and your shoulders should be back slightly. Slowly squeeze your shoulder blades together as hard and far as possible provided it does not cause or increase symptoms (figure 2). Hold for 5 seconds and repeat 10 times.



Pendular Exercises
Begin leaning forwards with your uninjured forearm supported on a table or bench. Keeping your back straight and your shoulder relaxed, gently swing your injured arm forwards and backwards as far as you can go without pain and provided you feel either nothing, or, no more than a mild to moderate stretch (figure 3). Repeat 10 times provided the exercise does not cause or increase symptoms. Repeat the exercise swinging your arm side to side provided it is pain free.