Treating Trigger Points in the Biceps

Biceps Brachii Muscle

Treating Trigger Points in Biceps Brachii - Dr. Jonathan Kuttner M.D.

Trigger Points in the biceps are often associated with shoulder, back, and elbow pain

The biceps brachii decelerates extension and pronation at the elbow and extension at the shoulder joint.

It acts as a junction providing myofascial continuity between the thumb and the ribcage (especially obvious when the upper limb is abducted).

The muscle plays a vital role in shoulder stability under dynamic conditions, and can contract with the triceps brachii to stabilize the elbow.

Trigger Points

Myofascial trigger points typically evolve in the center of the belly and refer pain up toward the anterior deltoid and down toward the pronator teres, just distal to the elbow joint.

The neuromuscular therapy hypothesis includes weak core stability with poor neuromuscular efficiency, culminating in compensatory myofascial trigger point formation to provide additional tension.

Trigger points form in this muscle for a wide range of reasons including repetitive motion injuries, throwing/sports induced (e.g. basketball, tennis), lifting heavy objects with the palm upward (ex. weight training), musical instrument playing (ex. violin, guitar).

Biceps Trigger Points

Biceps Brachii - trigger points typically evolve in the center of the muscle belly

Latin, Biceps, "two-headed muscle"; Brachii, "of the arm".

Biceps Brachii operates over three joints. It has two tendinous heads at its origin and two tendinous insertions. Occasionally it has a third head, originating at the insertion of coracobrachialis.

The short head forms part of the lateral wall of the axilla, along with coracobrachialis and the humerus.

Basic Functional Movement

Picking up an object. Bringing food to mouth.

Trigger Point Indications

Anterior shoulder pain with decreased arm extension. Biceps tendonitis. Reduced extension of arms. Reduced Apley’s scratch test manoeuvre. Frozen shoulder syndrome.

Biceps - Common Referred Pain Patterns

Referred Pain Patterns

Localized pain with intense ellipse superficially located over the long head tendon. Referred pain into anterior cubital fossa.

Consider Also ...

Subscapularis. Infraspinatus. Brachialis. Supinator. Upper trapezius. Coracobrachialis. Triceps brachii.

General Advice to Client

Exercise antagonists (Triceps Brachii). Reduce load on Biceps Brachii when carrying with a bent arm. Adjust sleeping position and work posture.

Self Help

Self help techniques can be quite effective. Try using your finger tips, a hard ball, or a pressure tool to massage the area (see image below).

Biceps Trigger Point Self Help

Stretching

Stretching between treatments can also help to dissipate trigger points. See image and instructions below.

Technique

Stand upright and clasp your hands together behind your back. Slowly lift your hands upward.

Do not lean forward while lifting your hands upward.

Muscles Being Stretched

Primary muscle: Anterior deltoid.
Secondary muscles. Biceps brachii. Brachialis. Coracobrachialis.

Injury Where Stretch Might Be Useful

Dislocation. Subluxation. Acromioclavicular separation. Sternoclavicular separation. Impingement syndrome. Rotator cuff tendonitis. Shoulder bursitis. Frozen shoulder (adhesive capsulitis). Chest strain. Pectoral muscle insertion inflammation.