The bicep is made up of two heads. The long head attaches to the shoulder
blade on the supraglenoid tubercle. The short head attaches to the shoulder
blade on the coracoid process. Both run together and attach to the forearm on
the tuberosity of the radius. The main movement is flexion of the elbow with
supination of the forearm.
Two Tests Which May Indicate the Pain is Coming from your Neck:
Neck Compression Test: Spurling Test: Extend your head back. With your neck
extended, tilt your head to the painful side. Hold this position for 30 seconds. If
you feel neck pain, pain, tingling that radiates down the arm, or numbness,
then you have tested positive.
Median nerve tension test: Test non-painful arm first. Extend your arm (elbow)
out to the side of you. Turn the wrist outward so the palm is facing away from the body.
Extend your wrist and laterally bend your neck away from the arm. Side bends your
neck away from the pain while extending the wrist and hand. Repeat the same
test on the painful arm. If you cannot extend the elbow or the wrist without increased pain and/or symptoms you have tested positive for the median arm tension test. This could be a pinched nerve in your neck.
Radial nerve tension test: Test unaffected arm first. With the arm at your side, take your hand and twist so it is facing palm out. Flip your hand up so the palm is now facing the ceiling. Side bend neck away from hand. Repeat the same test on the painful arm. If you cannot obtain the described position without increased pain and/or symptoms you have tested positive for the radial arm tension test.
A bicep strain occurs when the bicep muscle becomes stretched beyond its limit. This excessive stretching may cause a “muscle strain”, a “muscle tear’, or a “muscle pull”. All three descriptions refer to damage to a muscle or its attaching tendon.
The injury to the hip muscle or muscle tendon may be graded according to the severity:
• 1 st degree
o The hip muscle may be sore but there was only mild over-stretching of a muscle.
• 2 nd degree
o Mild swelling and bruising but possible severe muscle pain and tenderness. Moderate over-stretching of the bicep muscle with some tearing of the fibers.
• 3 rd degree
o Severe pain and swelling. Muscle or tendon is torn all the way through. The muscle is either ripped into two separate pieces or sheared away from the tendon. This can cause a complete loss of function and may require surgery.
Anyone can strain their bicep muscles from just daily tasks, but more often a tear occurs while lifting something heavy. The strain or tear can occur at the tendon which is the thick band that attaches the bicep muscle to the bone or in the muscle itself. The injury can occur at the end of one of the heads (long or short) (in the shoulder). Or it can occur at the attachment in the forearm. Both can happen because of age-related wear and tear. And finally, the injury could happen in the muscle belly itself.
How to make sure the pain is not coming from your neck:
You have a higher chance of experiencing a bicep strain if:
1. You have had a prior bicep strain or tear.
2. You have muscle tightness.
3. You fail to warm up before an athletic or work event.
4. You attempt to lift too much with exercise or work.
Signs and Symptoms of a Bicep Strain or Tear:
1. Swelling and bruising (discoloration)
2. Muscle spasms
3. Previous bicep strain or tear
4. You can feel point tenderness.
5. Might feel an indentation or bump in the muscle.
6. Pain when that muscle is used.
7. Weakness when that muscle is used.
8. Hearing a “pop” sound when the muscle or tendon was injured.
Three self-tests you can do:
1. Hook test
a. Elbow is held at 90 degrees. Try to hook your opposite finger under the tendon by the elbow. If able to do so the tendon is intact. If the tendon is injured it may be tender.
2. Popeye’s sign
a. If you have a rupture at any of the bicep attachments the muscle may bunch up in the middle of the arm. A rupture at the long or short head usually does not have to be repaired. A rupture near the elbow usually is repaired.
3. Feel for point tenderness over the muscle belly (tenderness may indicate a muscle tear).
X-rays may be ordered to make certain a bone fracture did not occur with a strain or tear.
Treatment:
1. If tender, cross fiber friction massage over the long head tendon, short head tendon, insertion tendon in the forearm, or muscle belly.
2. Try massage, (use finger over the finger, or side to side). Be aggressive over the tender area and deep. If tender massage for 30-60 seconds and assess. If plateauing or decreasing you may continue. If increasing you must stop and try another day.
3. In all cases you should also massage the nontender areas of the bicep muscle belly.
4. If able to tolerate the cross-fiber massage may do up to 20 minutes or 5 minutes (4x a day) every other day.
Use of massage gun - ball or pointer attachment.
This video is part of a series of videos on how to treat your pain with self-massage. Check the full series of videos along with the downloadable guide sheets for each video on our website here: https://www.bobandbrad.com/massage/
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