The Relationship Between Glenohumeral External Rotation and Long Head Biceps Tendinopathy: Understanding and Treatment
For sports enthusiasts, the shoulder is not only one of the most complex joints in the body, but also one of the most stressed, especially in sports that require throwing or lifting movements. Understanding how the long head of the biceps brachii (LHB) works and how to prevent problems can make a difference in your sports routine.
Think of the CLB as a string that connects the top of your shoulder blade to your arm. During external rotation, when your arm rotates externally, this “string” becomes tight and can rub against the bone, causing irritation, much like a string that frays when dragged repeatedly over a rough surface.
When the CLB is put under too much stress, a variety of problems can arise. It’s like the tendon is stuck, causing pain, or like guitar strings that wear out after too much use. Also, if you force the rotation too much, the labrum—the cushion that helps the shoulder move smoothly—can become damaged.
Before considering drastic solutions such as surgery, there are some essential steps that every athlete should consider. It is important to give your shoulder some respite by avoiding movements that aggravate the pain. Specific exercises to strengthen and stretch the shoulder muscles are crucial, as is a good warm-up before physical activity. The use of ice after intense training and ultrasound can help reduce pain and inflammation. For more persistent cases, corticosteroid injections or PRP may be an option to be considered with caution, given their ability to relieve inflammation and pain.
If conservative treatments do not bring the desired relief, techniques such as tenotomy or tenodesis may be considered as a last resort to free you from chronic pain.
Monitoring how your body responds to treatments is key to staying fit and active. Finding effective strategies to manage pain is crucial so you don’t compromise your passion for sports.
Keeping your shoulder healthy means understanding the biomechanics of CLB and managing symptoms before they become an insurmountable obstacle. With a thoughtful, personalized approach, you can continue to do what you love without being held back by pain.
How to Approach Long Head Biceps Rehabilitation?
Fortunately, with a well-structured rehabilitation plan and following some specific exercises, you can speed up your recovery and come back stronger than ever. Here is a detailed guide to help you understand and implement the crucial steps of CLB rehabilitation.
Phase 1: Reduction of Pain and Inflammation
Rest and Activity Modification
The first step is to reduce the activities that aggravate the pain. This does not mean stopping completely, but rather adjusting your workouts to avoid movements that stress the biceps.
Cryotherapy
Applying ice packs to your shoulder for 15 to 20 minutes several times a day can help reduce inflammation and pain.
Electrotherapy
Technologies such as TENS (Transcutaneous Electrical Nerve Stimulation) can be used to relieve pain through electrical impulses that help block pain signals from being sent to the brain.
Phase 2: Mobility Recovery
Bicep Stretch
A gentle but effective stretch is the "Wall Bicep Stretch." Stand with your arm extended and your palm flat against a wall. Slowly turn your body to the opposite side to stretch your bicep. Hold for 15-20 seconds and repeat 3-5 times.
Joint Mobilization
The "Shoulder Stick Mobilization" is a great exercise. Using a stick held in both hands, move your shoulder in different directions (rotations, elevations) to improve mobility without overloading the tendon.
Phase 3: Muscle Strengthening
Isometric Exercises
"Bicep Isometric Exercises" are the starting point for strengthening. Without moving your elbow, try to contract your biceps against a static resistance, such as a wall, for 5-10 seconds. Repeat for 10 sets.
Exercises with Elastic Bands
Use resistance bands for exercises like "Resistance Band Bicep Curls." Secure the band to a fixed object at floor level and perform bicep curls. This helps build strength without overloading the tendon.
Phase 4: Integration of Functional Activities
Compound Exercises
As your pain decreases and your strength increases, incorporate exercises that engage multiple muscle groups. For example, "Band Rows" not only work your biceps but also your back, improving overall stability.
Sports Movement Simulations
Start incorporating movements that mimic your sports activities, but at a lower intensity. For example, if you play tennis, work on controlled swings without using a racket, focusing on proper form and alignment.
Conclusion
Recovering from CLB pain and injury requires patience and consistency. By following these steps, you can not only recover faster, but also prevent future injuries. Remember, every exercise should be performed pain-free. If you feel pain, take a step back and consult with a physical therapist (you can email me directly at @diegoauriemma.physio.coach) to ensure your routine is appropriate for your level of recovery. With the right approach, you will soon be ready to get back to doing what you love most, without limitations.
In conclusion, the rehabilitation of the long head of the biceps is a journey that requires commitment and dedication, but with the right approaches, complete recovery is well within your reach. Each phase of the rehabilitation process is crucial and builds the foundation for a stronger and more resilient shoulder. Follow these exercises carefully and listen to your body: patience and consistency are your best allies on the path to recovery.
Stay tuned to our blog for more details and updates on sports injury treatment and best practices for rehabilitation. We have a variety of interesting content that will help you stay fit and prevent future injuries. Don't miss out on future articles where we will delve into more advanced techniques and share tips directly from the professionals in the field. Your health and well-being are our priority, and we are here to support you every step of the way on your sports journey. See you soon!