Chiropractor Chandler AZ
The bicep muscle is very easy to visualize - it is one of the muscles that everybody knows. Many of us, from a certain generation, think of Popeye popping out his biceps with a little spinach. With his increased muscle mass he showed incredible strength to beat of the bad guys and save Olive Oil.
Popeye not only had incredible bicep muscle strength, but he also had excellent strong tendons attached to his muscles. Many chronic repetitive use injuries damage the tendons more than the muscles. Both muscles and tendons respond to stress and strain placed upon them. When working out over time, both the muscles and tendons lay down more fibers to make them stronger to handle the increased stress loads.
The bicep tendon is very commonly injured, especially in people who have a head forward and rounded shoulder posture. The rounding shoulder places more stress and strain to the bicep tendons in the front of the shoulder with our normal arm motions and movements. This increases the likelihood of bicep sprains with household chores, sporting events, working out, or lifting weights.
The bicep muscle is named because it has two muscle heads in the upper arm that fuse together to form one tendon that attaches at the elbow. The long head of the bicep tendon crosses above the head of the humerus to attach onto the shoulder at the glenoid. The short head of the bicep muscle attaches to the coracoid process as it runs down to meet the long head of the bicep muscle where it fuses. The bicep muscle helps flex the elbow and the shoulder. We also use these muscles and tendons when lifting a heavy box to help stabilize, or slowing our arms down during a golf or baseball swing.
The bicep muscle works with the subscapularis, teres minor, supraspinatus, infraspinatus, pectoralis major, pectoralis minor, and tricep muscles to perform many of our shoulder activities and stabilize the shoulder joint. The ball and socket joint allows for an incredible amount of motion and movements, but the extra motion was produced by limiting the supportive ligaments and bone structures that protect many of the body’s other joints. The shoulder relies heavily on the muscles that cross the joint for protection and stability, and to limit the shearing forces across the joint that could damage the cartilage and bone.
The long head of the bicep tendon runs in a small groove between the greater tubercle and lesser tubercle at the top of the shoulder. This long tendon is traveling down before it becomes muscle. Chronic injuries to the tendon may lead to a complete rupture, causing the rest of the tendon to be pulled down towards the muscle fibers. You may have seen this in pictures where someone flexes their arm and it looks like they have a big bump in their bicep. The large Popeye-looking bump is the result of the tendon rupturing and the rest of the muscle being pulled into a ball.
Fortunately most tendon sprains produce acute pain in the tendon that lets people know it is time to reduce the stress and strain before a rupture occurs. Bicep tendinitis can be treated at home with light ice, stretching, and shoulder stability exercises. All exercises and stretches should be performed in a pain-free manner to reduce additional damage to the bicep tendon. Ice is an excellent treatment for decreasing pain and inflammation associated with tendinitis or any tendon injury. Heat can be used at a later time to increase blood flow and enhance healing.
Many patients with bicep tendinitis develop the condition is a result of weakness or lack of shoulder stability. Chiropractic and physical therapy treatments can be utilized to strengthen the shoulder and decrease the muscle spasms associated with the injuries. Massage therapy, Graston technique, or active release technique are common treatments used on many different types of shoulder injuries. They are often used in supraspinatus, rotator cuff, teres, and AC sprains. These treatments are excellent at addressing the muscle fiber scar tissue or fascial adhesions that have developed over time and use. Most patients respond very well to these treatments and notice a dramatic increase in their flexibility and function.
This is especially noticeable when the muscle techniques are combined with shoulder stability exercises to enhance the coordination and function of the shoulder muscles. Many patients have slowly lost strength in some of their muscles, which causes the body to tighten and spasm other muscles. Eventually the shoulder is using the wrong muscles to perform normal actions and activities. Initial strengthening exercises are performed in one plane with a weight or rubber band. Then multi-plane exercises and stretches can be utilized to enhance the stability and coordination the muscles.
Common stability exercises utilize an exercise ball or vibration plate. Vibration plates create forward and backward movements that help knock the body off balance, which requires the shoulder muscles to work even harder to stabilize themselves. Push-ups on a vibration plate seem incredibly harder than when they are performed on a solid surface such as the ground. In addition to vibration to create an unstable surface, exercise balls are inexpensive equipment people can use at the home or gym. The exercise ball further challenges the shoulder muscles to stabilize and work together when holding a plank or push-up position. Performing a push-up on the exercise ball is once again much harder than many people anticipate. If patients are unable to safely perform push-ups on an exercise ball without increasing their shoulder pain, the exercises can be modified to be performed on a wall or in a position that places less pressure on the shoulders.
Vibration plates and exercise balls are excellent shoulder stability activities that reduce the likelihood of further injuries and shoulder tendinitis. Active exercise programs and plans are especially needed in patients who have had multiple shoulder injuries, shoulder surgeries, or tendinitis episodes over the years.
Class IV cold lasers are excellent treatments for decreasing pain and inflammation in all tendon injuries like the bicep tendon which can show multiple small areas of damage over years of overuse and chronic repetitive activities. Each of these sites are going through at regeneration and cellular repair process. Cold laser enhances the fibroblast activity and repair that needs to occur on the tendon. It helps accelerate healing by increasing the ATP production within a cell. Injured cells often have low levels of ATP, which slows their healing and repair. ATP is the energy’s source for all cells and their metabolic activities. Cold laser stimulates the enzymes that produce ATP, which ramps up production and creates a surplus of energy which the cell will use for repair.
In addition to accelerating energy production with the cell, cold laser also enhances blood flow to the tissue. Increase blood flow brings more nutrients that are needed for the repair process. It also brings more oxygen which is needed for the increased ATP supply. Increase blood flow, or vasodilation, enhances the body's ability to wash away the waste products and swelling that surrounds injured tissue.
Low level lasers are an excellent treatment for any repair and regeneration process in muscles, tendons, ligaments, and joints. The long bicep tendon is especially at risk for tendinosis or tendinitis injuries. Chronic injuries to this area increase the likelihood of ruptures and chronic pain. Proper treatment can help reduce the likelihood of chronic injuries to the tendon and shoulder muscles, thereby reducing the long-term risks and pain associated with repetitive shoulder motions and movements.