T Nation

Biceps Tendon Injury


I've been training heavy for about 8 years and have never suffered any major injuries until my right shoulder started having pain about a year ago. Slowly the shoulder pain got worse and turned into elbow tendonitis on the same arm. I took about 4 weeks completely off and nothing changed. After seeing 4 different physical therapists and spending a ton of money it was finally determined my biceps tendon keeps slipping out of the Bicepetal groove and causing irritation/inflammation.

My PT will put it back into the groove with some ART and manipulation only for it to come back out the following day or following training session and start causing pain and irritation again. I'm worried that I'm eventually going to tear the tendon which my PT says is a strong possibility. He also stated the tendon can build up scar tissue and eventually not even fit into the groove anymore, which seems like may have already begun.

Does anyone have any advice or personal experience with this type of injury? I've been told it's pretty common in weight lifters and some throwing sports.



One issue is that is the biceps tendon comes out with too much force (e.g. something slips during a deadlift) it can tear your labrum. This is because it passes through a sheaf connected to the labrum. It can also blow out your subscapularis (biggest and strongest rotator cuff muscles). The latter happened to me -- partial tear with tendon rupture some years back the full subscap tear. Just had it re-attached.

It is a waste of money to have the PT put it back in, unless they really know of a way to make it stay. By all means try conservative options but look into either a biceps tedonesis (re-attach it elsewhere) or a tenotomy (just cut it). Remember that the long head of the biceps works as a shoulder stabilizer too, so you might actually be seeing a symptom of a shoulder dysfunction. That's the first place I would look for a conservative approach. If you can figure out why it is getting so stressed, maybe you can modify your training to avoid it. Surgical options are a last resort, but read up on them so you can get a good idea what it means for this to take a turn for the worse. Better to know that now and keep an eye on it.

-- jj