Welcome to the gun show!

You guessed it! The
guns we are referring to are the biceps.
In this article, we will discuss proper motion, common injuries,
exercises and things not to do at the gym!
The biceps brachii have two muscle bellies and attach the
shoulder to the elbow. For those that
would like to know more specific anatomy, the short head, attaches to the
coracoid process of the scapula and the long head attaches to the supra glenoid
tubercle of the scapula. Together, both
muscle bellies come together to form a single tendon at the elbow which inserts
at the radial tuberosity on the radius.
The action of the biceps brachii is to flex the elbow, flex
the shoulder and also, often forgotten, is supination of the forearm, or the
motion of turning your palm up.
Some of the common injuries we see with the biceps include
strains, tendonitis, ruptures of the biceps tendon or the transverse humeral
ligament. Less common injuries are lesions to the tendon at their insertion
points (SLAP injuries). Strains are probably the most common biceps injury. This typically involves an overuse injury while
lifting a heavy object, either at home or the gym. Most of us often get biceps strains to a mild
extent when we overdo it at that gym.
This is the pain we experience that lasts more than 1 or 2 days post
workout. Another mode of onset that
often occurs that results in a strain is a quick deceleration of the muscle
ending with a contraction while the muscle is in its lengthened position. For example reaching forward to catch
something of weight, often too heavy for you.
Strains are cared for with your P.R.I.C.E protocol, Protect, Rest, Ice, Compress and Elevate. After 72 hours,
soft tissue techniques like massage, myofascial release, cupping, etc… can be
used to assist with the healing process.
The main goal with these soft tissue treatments is to align the muscle
fibers and help break apart any scar tissue that has already formed or is in
the process of forming.
Tendonopathy is a term used to describe the collection of
different tendon injuries (tendonitis, tenosynovitis, tendonosis, or
paratendonitis). The difference in the
terminology is the anatomical structure that is involved and/or if there is
inflammation or degeneration. Depending
on the structure that is involved, the treatment will vary slightly. If there is an inflammatory process involved,
the obvious treatment is to reduce the inflammation. Ice, laser, ultrasound treatment or
anti-inflammatories will help with inflammation. Some more severe cases will require steroid injections
to control or eliminate the inflammation.
When degeneration is the problem with the tendon, treatment will focus
more on strengthening the muscle under closely monitored rehab program.
Tendon or ligament ruptures can occur at any age. Generally, we will tend to see more biceps
tendon ruptures in individuals over the age of 50 as a result of pre-existing
degeneration. The biceps can rupture at
the elbow or at the upper at upper scapular attachment. When the tendon ruptures at the elbow, the
muscle belly of the biceps will recoil up the arm, giving the “Popeye“ look or
a bulge towards the upper part of the arm.
The opposite will happen when the tendon ruptures from the other attachment
site. Another area of rupture, is at the
transverse humeral ligament. This is a small ligament that holds the biceps
tendon in the groove in the humerus.
With an excessive load, the transverse humeral ligament will rupture, causing
the biceps tendon to pop in and out of the groove resulting in pain and over
time, fraying of the tendon due to the repetitive tendon microtrauma or
eventually rupturing the biceps tendon.
Surgery for any of these various ruptures will be dependent on the age
of the patient and the impairment. The
majority of ruptures are left alone because biceps function is only diminished
by 20-30%.
Exercising your
biceps.
As we discussed, the action of the biceps is to flex the
elbow, shoulder and supinate the forearm.
https://www.youtube.com/watch?v=jGwGRmRS2xA
When we exercise the biceps, we want to incorporate all of
these actions. Biceps curls are a common
exercise I’m sure we have all done in the past.
You can do all kinds of variations on the biceps curl based on your
positioning, single arm vs two arms, timing (up 2, down 2) and constant vs
variable resistance (weight or resistance band).
Check out this video on different variations of biceps exercises
to add to your workout routine.
https://www.youtube.com/watch?v=bf0Ip4DW8y4
In addition, I like to add exercises for the whole shoulder exercising
multiple muscles at once. These types of
exercises are considered functional motions, or motions that would be used in
more everyday motions. A functional
exercise that would emphasize the whole motion of the biceps, elbow flexion,
supination and shoulder flexion, would be a chin up with palms facing towards
you. Another functional exercise would
be lifting a weight or resistance band from the ground up and over the head.
There are a lot of mistakes I see in the gym. The most common mistakes when training the
biceps in isolation, or any other muscle, would include recruiting other muscle
groups unintentionally. Often,
individuals will go for the larger weight in the gym to do their bicep curls,
only to sway at their spine and hips. If
form is compromised, then the work is not really effective. Lift the weight that allows you to maintain
proper and complete form.
When you are ready to work on developing your biceps, I hope
you consider the information above. Most
importantly remember that the bicep muscles control essential movements, so don’t
try strengthening them without proper technique.