Distal Biceps Tendinopathy typically presents after overusing the biceps; these muscles are elbow flexors (bending) and forearm supinator’s (palm towards the ceiling), think bicep curls. This overuse creates tendon degeneration. This is a relatively uncommon diagnosis, resulting in little evidence regarding best practice.
WHAT TO CHECK:
Typically, there will be pain as you activate the biceps. There may also be recreation of pain with palpation, to find the distal biceps you can flex the biceps to locate the distal tendon. There may also be some discomfort when you stretch this region, which is achieved by extending the elbow, pronating your forearm, and extending your shoulder.
WHAT TO AVOID:
Avoid loading your biceps with very heavyweights. The two actions of the biceps are to bend the elbow and turning the palm up. Be careful with sports that include lots of elbow movements such as weightlifting, rock climbing, or gymnastics. If you do perform a curl or a row, make sure it is performed slow and controlled. On the eccentric component of the movement/the lowering portion is typically where people will strain this tendon. The tendon will need load as part of the rehab process, the key is to slowly progress how much you load this region.
WHAT TO EXPECT:
Just like most tendinopathies, the rehab process is very slow. It may take a few months to get back to using that tendon pain-free.
1. Jayaseelan D, Magrum E. Eccentric training for the rehabilitation of a high level wrestler with distal biceps tendinosis. A case report. Int J Sports Phys There. 2012 Aug; 7 (4): 413-424