People complain of a strip of pain in the front of the shoulder when reaching up. They often say this is “biceps tendon pain” because it feels more superficial. When I ask if there is a motion that creates the pain, they lift their arm in front of them. It bothers them more as the elbow moves above the shoulder. They may not get that rotating the palm up causes more pain until I ask them to try it.
Patients often point out that the shoulder rolled forward. They usually haven’t noticed that it comes from the habitually bent elbow. This biceps problem causes the elbow to bend when standing in a relaxed state.
When the pain around the elbow is present, they have trouble straightening the elbow completely. People complain of pain in the elbow pain less often. I explore that complaint in this other post.
If they have an activity associated with the pain, it often involves jarring or jerking the shoulder. Research talks about the onset of pain from a powerful backhand in tennis. My clients usually had some overload while lifting something with the elbow bent. They may have been carrying bags in the yard or tried to move a heavy piece of furniture with the elbow bent. One woman was handed an unexpectedly heavy child. There is an underlying shoulder joint problem in these cases, and this is an injury waiting to happen. Clients report being jerked by the tailgate of their SUV as it lifts.
The other typical onset is vigorous or chronic overuse. This typically involves too much exercise, yard work, or remodeling. This can be strained with heavy curls or chin-up (palms facing you) when exercising. Hauling blocks or bags that require you to keep your elbows bent stress this trigger point.
People may complain that the pain disturbs their sleep if they hold their hands close to their face. In this case, the trigger point has become more chronic.
The biceps brachii is complex in its anatomy and how it behaves in the upper arm. Read more in this post about the anatomy of biceps brachii.
This post has strategies for getting relief on your own. Explore how to change your activities, stretch, and other strategies that relieve the pain associated with this trigger point.
This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.
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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written materials and instructed classes since the mid-90s. This includes anatomy, trigger points, cranial, and neuromuscular.
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