Trigger Point Therapy for Painful and Tight Biceps
Biceps Brachii Muscle
Whether you are just starting out on your fitness journey or you have been training for years, there are many things to keep in mind when it comes to the Biceps Brachii Muscle. This article will help you understand the anatomy of the muscle, the common injuries that can affect it, and how to stretch and maintain it.
Biceps Anatomy
Known as the biceps brachii, this muscle lies superficial to the brachialis muscle and is situated on the ventral part of the upper arm. Its function is to flex the elbow and to rotate the forearm. The biceps brachii muscle is a large, fusiform muscle that is composed of two bundles, each with a common insertion point near the elbow. The long head of the biceps brachii muscle originates from the supraglenoid tubercle of the scapula, and passes through the intertubercular groove of the proximal humerus. The tendon of the long biceps brachii muscle continues through the bicipital groove and merges with the periosteum of the radius at the radial tuberosity.
The short head of the biceps brachii originates from the coracoid process of the scapula. It is a thick flattened tendon that passes adjacent to the tendon of the Coracobrachialis.
For details see diagram above and video below.
Biceps and Trigger Points
Identifying active trigger points (TrPs) is an important aspect of diagnosis of myofascial pain. These "knots" form in muscles and cause stress on muscle fibers.
In this study, two pairs of raters palpated bilaterally three shoulder muscles, infraspinatus, biceps brachii and levator scapulae. Intrarater reliability of physical examination tests were assessed with a kappa coefficient. However, these findings cannot be generalized to all shoulder muscles.
Infraspinatus and biceps brachii muscles had a lower agreement than the anterior deltoid muscle. The posterior deltoid muscle had acceptable agreement. However, this could be because raters had difficulty identifying trigger points in this muscle.
The most reliable features of trigger points were jump sign and referred pain. Raters had acceptable pair-wise agreement on all aspects of examination.
Common Biceps injuries
Whether it is a partial tear or a ruptured bicep, biceps injuries can occur from a variety of different causes. Some of these can be painful, while others can take months to recover from. The key to recovering from an injury is allowing the muscle to heal itself.
The biceps tendon is a tough band of connective tissue that attaches to bones in the shoulder. It is prone to damage from overuse. Depending on the severity of the injury, it may require surgery to repair. Surgical treatment is usually a last resort.
The most common injuries in the biceps are strains and avulsions. This type of injury occurs when the muscle-tendon unit becomes overloaded. Overload can be caused by repetitive overhead motions, such as throwing.
Sports Massage and Trigger Point Therapy
Whether you are a massage therapist or a patient, you have probably heard of trigger points. These tiny clusters of tissue are the result of an adverse stimulus or a chronic condition. In response to a trigger point, a muscle contracts briefly and then relaxes.
These trigger points can cause shoulder pain. Massage can help alleviate the pain. In addition, massage therapy can break up adhesions and restore normal soft tissue mobility.
Trigger point therapy uses concentrated pressure and a specific position to stimulate the point. The therapist uses their finger or elbow to make contact with the point. In addition, the client may participate by holding the point. The therapist holds the pressure for 10-30 seconds.
Muscle compression is another method of trigger point therapy. This technique involves the client participating by using gentle isometric contractions.
Trigger Points in the Biceps are associated with many painful shoulder conditions including frozen shoulder
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. It has been described as the muscle that puts in the corkscrew and pulls out the cork!
Problems with the biceps tendon can result from impingement or from inflammation and can also occur secondary to, or as a result of, compensation for other shoulder disorders.
Diagnosis
Diagnosis can often be difficult because of the complexity of the shoulder, and because it is common for several different problems to exist in the same shoulder at the same time.
This can create a sometimes confusing clinical picture.
Biceps injuries can occur for a whole host of reasons but are definitely more common among those who engage in frequent pulling, lifting, reaching or throwing, and with repetitive overhead activity.
Trigger Points and the Biceps
Trigger points are almost always associated with Biceps tendinitis.
However, biceps trigger points are also commonly linked with non-specific anterior shoulder pain (usually with decreased arm extension), and play a key role in frozen shoulder syndrome.
Biceps tendonitis is extremely common. It occurs in the long head of the biceps tendon as it runs on the anterior aspect of the humerus between the attachments of the supraspinatus (greater tuberosity) and subscapularis (lesser tuberosity).
Trigger points typically evolve in the center of the gaster 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 trigger point formation to provide additional tension.
The LHB tendon is unique in that it inserts inside the capsule of the joint to attach directly to the socket bone (lower glenoid fossa).
This means that inflammation tends to start lower down the tendon and can track upwards directly into the ball and socket joint causing havoc; as is the case in frozen shoulder syndrome.
Biceps Brachii Trigger Points - Pain Pattern
TrPt Treatment Summary
Trigger points in the biceps can be quite stubborn and require a certain amount of skill and experience to treat effectively, although even a little bit of well targeted self-help can often make a difference.
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