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Biceps Tendinopathy: Symptoms and Solutions

What is Biceps Tendinopathy?

The biceps brachii muscle, commonly known as the biceps, sits between the shoulder and elbow. It has two parts: the long head and short heads. These come together to form the main muscle bulk, which is the “Popeye” part of your upper arm. The biceps brachii muscle runs from the top and front of the shoulder all the way down to the upper forearm. The biceps tendon is the part that attaches the muscle to the bone, both at the shoulder and the elbow.

The biceps muscle functions to bend the elbow and turn the hand to face palm-up. The term “tendinopathy” is used to describe injury and pain of a tendon. This is most commonly due to overuse. Biceps tendinitis tends to affect the long head of the biceps more commonly. Both the tendon itself and the tendon sheath can be the source of pain.

How does it happen?

This condition occurs most commonly due to repeated use of the biceps over a long period of time. People with this condition often present in the later stages of tendon damage, when they begin to experience pain. This means that biceps tendinopathy is a slow-developing condition, without any symptoms until it reaches the point that the tissues become injured and painful. This is the body’s way of self-defence; it is telling you that it doesn’t like the activity you are asking it to do.

While specific tasks such as throwing sports, tennis or golf can increase the risk of developing a biceps tendinopathy, often it is simply caused by usual daily activities throughout the course of an adult’s life. With aging comes a decrease in the collagen and elastin components of tendons. This contributes to a reduced ability to sustain a high load, which can cause degeneration or inflammation over a longer period of time.

What are the symptoms?

Biceps tendinitis is painful; often aching at night and increasing in intensity when performing overhead tasks such as reaching and lifting. The pain is usually at the front of the shoulder and can radiate downwards along the front of the arm.

People with this condition often have developed adaptations to their usual movement patterns in order to avoid aggravating this pain. This in itself can lead to other issues such as strained or overworked muscles. An example of this is hitching up the shoulder to the ear when going to use the affected side, as this will help to offload the affected muscle, allowing the biceps to be under less stress. Unfortunately, this will eventually increase the stress on the muscles of the upper neck and shoulder, leading to secondary aches and pains.

How can physiotherapy help?

Your physiotherapist will assess and diagnose this condition, which will, in turn, allow for a comprehensive management plan to be put in place. A combination of strengthening, stretching and muscle release is often beneficial to assist in the management of this condition.

If you have developed secondary complications with changes to your normal movement patterns, your physiotherapist can assist you in addressing these and training your body to avoid causing further damage.

If further imaging or onward referral is needed, your physiotherapist can help in guiding you through this process.

 

This information is not a replacement for proper medical advice. Contact our practice and speak with one of our physiotherapists for advice on your individual condition.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Where is your pain really coming from?

Have you ever been to see a physiotherapist for pain in one part of your body and, when they treated you, they focused on a completely different area?

While this can be a strange experience, it can be even more puzzling when the treatment actually works.

So what is going on? Shouldn’t pain be treated where it is being felt?

When pain is felt at a different location from where the pain is being caused, this is called ‘referred pain’ and is actually more common than you think. Exactly why this happens is a little complicated, and in fact, we don’t yet understand everything about the way that pain is processed.

Pain is usually felt when something causes damage to the body, sending an electrical impulse to the brain. The brain receives this information and process it to make sense of which part of the body the signal is coming from and what kind of pain it is.

When the brain thinks that the pain is coming from a different area than where the damage or signal is actually coming from, this creates the phenomenon of referred pain.

Referred Pain

Sometimes referred pain is easy to explain, such as when a nerve becomes injured or irritated, causing the pain to be felt along the length of the nerve. This often feels like a sharp, burning pain that runs in a strip, along the skin. Other examples of referred pain are more difficult to explain and in some cases seem to defy explanation. Perhaps you have heard about the strange phenomenon of phantom pain where amputees continue to feel pain as though it was in the place where their limbs used to be.

Muscular trigger points can also cause referred pain. The mechanism behind this is a bit trickier to understand, but is thought to be explained by tight bands of muscle tissues that cause pain to be felt in predictable patterns around the body.

Other tissues of the body can cause pain to be felt in a different location

This includes discs of the spine and internal organs. Many times the internal organs can refer pain in peculiar patterns and this can actually lead to serious illnesses being mistaken for muscular aches and pains.

Kidney pain can be felt in the lower back and tragically, some people fail to recognize that they are having a heart attack because they feel pain in their neck and arm, not in their chest.

We also know that not understanding or being afraid of pain can make pain feel stronger. In rare cases, people who have pain in one hand can feel pain just by seeing their other hand moving in a mirror.

There are many other fascinating aspects to pain, and understanding how it works is an important part of managing your symptoms.

To understand how referred pain may be affecting you, chat with one of our physiotherapists who can help answer your questions.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.
What is referred pain?

Referred pain: What is it and how can I manage it?

What is referred pain?

Referred pain occurs when pain presents in one area but the cause and origin are located elsewhere. This occurs due to sensory nerves being impacted with too high or low a signal being sent through the central nervous system.

The central nervous system sends messages to soft tissue, bones and organs throughout the body, potentially impacting these areas. Referred pain can be reported as; an ache, deep pain, pins and needles, numbness, or as pain in a specific area. Alternatively, you may get referred pain due to muscles or even your organs.

What are the common types of referred pain?

There are common types of complaints which include referred pain, such as; headaches, low back pain and knee arthritis.
Headaches can be referred pain from tight muscles or nerves at the base of the skull, around to the top of the head, temples and the jaw with the symptoms originating from the joints or muscles within the neck.

Experiencing pain in the back of the leg could be due to the irritation of the sciatic nerve in the lower back. Alternatively, low back pain can refer into the hip, groin, leg(s) or further up your back.

Arthritic changes occur when cartilage within the joint wears away. For example; within the knee, pain can be referred around the knee or in other areas of the leg due to the exposure of nerves within these areas.

Muscles may refer pain. Typically from trigger points within the muscle belly due to overuse or underuse. This could be because of poor posture, lack of movement or abnormal movement patters. Trigger points have distinctive referral patterns throughout the body.

Organs within the body can also refer pain. This is often described as a deep ache. This pain often won’t have a set pattern and you can experience pain far away from the affected organ. For example; the heart causing pain in the neck and/ or arm.

To help find the cause or to manage your referred pain talk to your physiotherapist at Caboolture physical therapy centre who can help manage your symptoms and answer any questions that you may have.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.
Workplace Ergonomics and your working posture

Workplace Ergonomics 101 – Your working posture

With an increasing number of jobs requiring you to sit in front of a computer for long periods of the day, it is important to address your working posture to protect your spinal health.

Here are a few simple adjustments that you can make to your workstation to help improve and protect your spinal health. Start with: 

  1. Adjusting your seat height so that your forearms can rest comfortably on the desk with your elbows at a 90-degree angle.
  2. Support your lower spine with the lumbar support of the chair sitting in the curve of your lower back.
  3. Have the screen/monitor sitting at a suitable height to prevent pushing your chin forward or having to look down to see the screen. (At a minimum, the bottom of the screen should be at eye level or slightly above).
  4. Where possible, try to have documents resting on an angled stand rather than sitting on the desk. This will prevent hunching over to read.
  5. Remember to take short breaks throughout the day. Stand up and stretch, this will assist in managing any lower back pain.

These are just a few strategies to prevent postural issues or spinal pain, our physiotherapists can offer further advice specific to each individual’s needs.

We also offer workplace ergonomic assessments, where our therapists will come to your work and assess your workstation. For more information, or to make a booking, phone one of our friendly staff on 5495 3255.

Below is an example of correct work posture:

Workplace Ergonomics 101

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Three stretches for the busy office worker

Sitting for long periods of time is often associated with a variety of chronic health conditions – which is bad news for us who work in an office. But there are ways to keep active and stay healthy, even when you’re sitting all day.

Move more often

Sitting itself and the posture you find yourself in isn’t as bad as simply being still for hours on end. An expression in physiotherapy is ‘the best posture is your next posture’. This means that, above all, movement is the best thing for your body and those in office jobs can find themselves becoming very still while focused on the next deadline.
Set a quiet alarm to remind you to move or change positions every 20 minutes. Getting up for phone calls and walking over to see colleagues when you have a question is a great way to break up your sitting time.

Reverse your posture

While not moving is definitely the worst aspect to prolonged sitting, the postures we often adopt while sitting can also be problematic. Sitting with a flattened lower back, hunched neck and slouched shoulders is the posture that requires the least energy to maintain and is often the one we sink into in a long day. A slouched posture can lead to shortened hamstring, hip flexor and pectoral muscles.

If you are spending large amounts of time sitting, it’s important to take time every day to adopt the opposite postures and keep your body flexible. 
This means moving into thoracic and lumbar extension, stretching your shoulders and extending your hips.

Here are a few stretches you can do every day while seated that will help to reverse your posture. Try to do these stretches every few hours during a working day.

1. Chest stretch

Sit forward, clasp your hands behind your back and lift your arms towards the ceiling. You should feel a stretch at the front of your chest. Look up slightly to increase the stretch. You should not feel any pain or tingling in your arms. Hold for 30 seconds and repeat.

2. Seated hamstring stretch

Perch on the edge of your seat and straighten one leg out in front of you. Lean forwards at your hips, keeping your back straight. You should feel a gentle stretch at the back of your thigh. If you feel the stretch behind your knee or into your calf, let your ankle relax, and let your foot drop towards the floor. Hold the stretch for 20 second then swap legs, repeat this stretch with each leg twice.

3. Chin Tuck

Sit up in your chair so your bottom is at the back of your seat and your lower back is supported. Relax your shoulders and gently tuck your chin in, imagine you are holding a soft ball under your chin and are slowly squashing it. You should feel a gentle stretch at the top of your neck. Hold for 20 seconds, release and repeat.

These stretches should not cause you pain. Speak to your physiotherapist for a customised stretching routine that you can implement into your day at the office or for more tips on how to perform these stretches to maximum effect. 

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.