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Best Exercises & Stretches for Bicep Tendonitis

by Jaydee Vykoukal, PT, DPT May 28, 2020 0 Comments

When managing the symptoms of bicep tendonitis, stretches and exercise can be a great place to start. Tendons respond well to a mix of stretching and strengthening to promote tissue recovery, and a combination of both can lay a solid foundation for upper arm health. Keep reading to learn more about bicep tendonitis stretches and exercises.

Stretches

Maintaining or restoring the flexibility of injured tissues in the upper arm is an important part of a balanced exercise program. These gentle stretches directly address the bicep in addition to surrounding affected areas.  

Median Nerve Stretch

It’s important to keep the median nerve pliable because it runs through the biceps muscle.  Make sure you keep your shoulder relaxed and in good posture as you bring your opposite hand to rest on the top of your shoulder, to stabilize. Then with your elbow straight and at your side, bring your head toward the opposite shoulder until a gentle stretch is felt in the neck and bicep. If tolerated, you can then progress the stretch by extending the wrist to a degree that is comfortable.

Move the wrist back and forth 15 times until the bicep starts to loosen up. If possible, then lift the arm slightly away from the body and repeat again. Keep slowly lifting your arm up out to the side, as high as 45 degrees.

Bicep Stretch

Stand or sit with the shoulders tucked back and your arm at your side. Then, let the elbow straighten as much as possible with the palm of your hand facing up. This may be enough to feel a good biceps stretch. If the elbow is completely straight, you then have the option to use the opposite hand to gently extend the wrist (back of the hand toward the floor) and hold.

Hold up to 60 seconds for 3 sets.

Supine Pec Stretch with Arms Out Straight

Lie on the floor on a foam roller or a rolled towel beach towel so that the entire spine and head are supported. Let your arms rest on the ground in a T-shape with the back of the hands resting on the floor. You will be focusing on one side at a time. To stretch the right side, rotate your entire body toward the left (while keeping the hand on the floor) until you feel a stretch in the right pec. Hold about 10 seconds before moving to the opposite side.

Repeat 10 times on each side. Focus on staying relaxed and do not let the low back arch.

Supine Pec Stretch in 90/90 Position

Lie in the same position as the last stretch on the floor, a towel roll, or a foam roller. Keep the entire spine in neutral alignment with the chin tucked and low back relatively straight. This time, the shoulders and elbow will both be bent to 90 degrees, making a touchdown position. Then, let gravity gradually pull the arms down toward the floor. You may feel some neural symptoms like tingling or numbness, if it gets painful then modify or stop the stretch.

Hold the stretch for 1-5 minutes.

Strength Exercises

Strengthening exercises should focus specifically on the biceps in addition to surrounding stabilizing muscles of the shoulder and shoulder blades. When the rotator cuff muscles and shoulder blades work in sync it decreases the overall strain on the injured bicep tendon. Always start with light weight and progress from there.   

Bicep Curls

This simple exercise requires a resistance band or light dumbbells. If using a resistance band to complete the biceps curl, step on the center of the band with both feet about hip-width apart and secure the ends in our hands. Otherwise, grab your weights. With the palms facing forward, shoulders down and neck relaxed, bend the elbow up toward the shoulder. Move slowly up for a count of 5 and down for a count of 5.

Repeat 10 times for up to 3 sets. Keep the palms facing forward throughout. Do not let the front of the shoulders come forward as you complete the exercise.

Bilateral External Rotation

Grab a light resistance band. Hold it loosely in both hands with the palms facing up and elbows tucked into the side (bent to 90 degrees). Keep good posture and gently squeeze the shoulder blades back to prevent the shoulder from jutting forward. Then, pull the hands away from each other as the shoulders rotate. Move outward as far as possible and hold for 5 seconds. You can adjust the level of resistance by adjusting your grip on the band.

Repeat 10-15 times for up to 3 sets. Keep the wrists straight and do not let your elbows leave your sides.

Internal Shoulder Rotation

Attach your resistance band to a door or stable object. Grab a rolled towel or pillow and place it between your bent elbow (to 90 degrees) and your side to help keep the shoulder in a good position. Stand sideways to the secured band with the arm you are focusing on facing the door. Place the band in your hand with the thumb facing upward. Then, bring the hand toward your belly as you internally rotate the shoulder. Keep the movement slow and controlled for a count of 2-3 seconds in each direction

Repeat 10-15 for up to 3 sets. Keep good posture with the shoulders back and the shoulder blades tucked throughout.

Standing Row

Secure the center of the resistance band in a door or around a stable object. Grab the loose ends of the band with both hands. Keep the elbows bent at 90 degrees with the palms facing each other, good posture, and abs tight. Squeeze the shoulder blades together while bringing the elbows back behind you. Keep the motion small and controlled.

Repeat 15 times for up to 3 sets. Do not let the neck tense up or lose form.

Shoulder Extension

Secure the band and keep good posture as noted in the exercise above. This time, the arms are straight as you extend the wrists behind the hips. Do not let your shoulders or head creep forward. Keep the motion controlled and tight.

Repeat 15 times for up to 3 sets.

Physical Therapy

Seeking care from a physical therapist is always a great way to recover from a musculoskeletal injury. With guidance from a skilled therapist, you will start by undergoing a thorough exam to determine the root cause of your injury. That way, you can collaborate on a personalized comprehensive program.

Exercise Program

Gain confidence and coordination as you work on a specific exercise program. Your PT will give you hands-on or verbal feedback for stretching, strengthening, balance, and range of motion exercises. The ultimate goal is to regain independence and function that is specific to your normal daily activities.

Pain Relief

A physical therapist is also an expert at pain relief. There are many possible options depending on your specific needs and preferences. Some will require an in-clinic approach while others will be prescribed for you to do at home. These include:

  • An ice pack or heating pad
  • TENs unit to address stiff, painful areas for short term relief (options for home or clinic)
  • Ultrasound  and light therapy treatment directly at the biceps tendon to promote deep healing
  • Manual therapy techniques including soft tissue massage, joint mobilization, myofascial release, deep tissue, trigger point release, and cross friction massage
  • Shoulder kinesio taping to promote better form and movement

Learn Proper Taping Techniques for Bicep Tendonitis

Education

The most powerful tool a PT can give you is the confidence to take care of yourself. You will gain an understanding of what caused your injury, how to properly treat it at home, and how to prevent future issues by addressing the root cause. Every PT patient should feel empowered to heal and recover sustainably.

How Physical Activity Can Help

Getting the arm and entire body moving are always great ways to promote overall health.  Focusing specifically on the biceps muscle and tendons has many added benefits, including:

  • Quicker recovery process and less downtime after injury
  • Increased blood flow to the bicep muscles and shoulder joint to allow healing
  • Reduced inflammation and shoulder pain
  • Confidence in use of your arm for daily activities
  • Improved muscle balance and strength
  • Prevent further progression of the injury
  • Increased tolerance for shoulder range of motion 
  • Better quality of life

Tips for Exercising with Tendonitis

An exercise program for biceps tendonitis requires a delicate balance of muscle activation and flexibility without causing further strain from overuse. Here are some quick tips:

  • Depending on the severity, you may need to take 1 to 4 weeks of rest to allow healing first
  • Warm up the area with heat, range of motion, or massage prior to exercise to prevent aggravation
  • Keep movement slow and controlled to minimize strain
  • Gradually build shoulder range of motion and strength as your symptoms allow
  • Discomfort is okay but a significant increase in pain or swelling is not 
  • With strengthening, focus on the return move
  • If you’re having a hard time tolerating motion, consider use of pain relief modalities first like ice or pain medication

Optimize your recovery by pairing your exercise program with other home treatment options

When and How Often Should I Exercise?

How frequently you should be exercising ultimately depends on the severity of your injury. Initially, you will benefit from gentle daily exercise. If you notice excessive muscle soreness or an increase in symptoms, it’s a sign you need a day or two of rest before proceeding further. As you heal and want to maintain the benefits you’ve gained, you will transition to doing your exercise program a couple times a week.

Caution with Stretches and Exercises

Biceps tendonitis can be tricky to navigate because it usually occurs with other shoulder issues related to the shoulder and rotator cuff. This is why a dynamic shoulder program is crucial. As you go through this program, pay attention to your symptoms and use them as a guide for what intensity to start at.

If you notice a sudden change in symptoms, onset of neural symptoms, or it is affecting your normal daily activities, seek medical advice as soon as possible from your physician or physical therapist.

Sources:

https://www.healthline.com/health/fitness-exercise/bicep-tendonitis-exercises#1

https://www.summitmedicalgroup.com/library/adult_health/sma_biceps_tendonitis_exercises/

SHOP BICEP TENDONITIS PRODUCTS

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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