Bicep Tendonitis/Impingement (Bill, EC, etc)

[kinney1]

I have made real progress with my personal shoulder dysfunction. Ortho, MRI, PT, and ART sessions have made a big difference. I went to a rehab place in North Jersey called Kinnetic Physical Therapy, which has focused on movement and examing flaws (tight hips) that could affect other body parts....Anyway, I seem to still have problems with the biciptial grove area. Are there any general recommendations for rehab exercises or strecthes for this area that you could recommend? Any kind of myofascial release I could do at home? I am a novice that is reading as much as I can on the internet to educate myself on this problem. Thanks in advance.

[Bill Hartman]

Not enough info.

What are the PT's saying is promoting the biceps issue?
What has helped (specifically. ART to your "?")?
What are you doing now?
What has the PT planned for you in the future?

Sometimes you just have to stay the course and give it time. Answer the above and maybe we can come up with something.

Bill

[kinney1]

Originally Posted by Bill Hartman

Not enough info.

What are the PT's saying is promoting the biceps issue?
What has helped (specifically. ART to your "?")?
What are you doing now?
What has the PT planned for you in the future?

Sometimes you just have to stay the course and give it time. Answer the above and maybe we can come up with something.

Bill

The PT's aren't saying what is promoting the bicep issue. Howver during ART sessions the PT's felt that the problem was the bicep as much as the shoulder. I can also tell you that MRI's have shown a mild impingement. I can tell you that I did WAY TOO MUCH bench pressing in my youth, and I now have the rounded shoulder look. I have had this problem for several years now. I have focused on my back muscles, and have done no bench presses in some time.

ART has been performed on the rotator cuff muscles, pec muscles, and my biceps. ART has defiently helped my situation.

I am currently doing a movement prep routine for my warmup, rotator cuff exercises, and some form of push/pull exercises that I vary. No overhead movements. Many of the push/pull exercises are being done with therabands for resistance. I also do squats or lunge variations with DB's. However, there is very little traditional stretching in the program.

I don't know what the future is in terms of exercises or stretches. I know that I want to continue to progress my rehab. Unfortuneately, ART and future PR sessions are expensive, so any advice is appreciated.

[Bill Hartman]

You need to address spinal mobility to restore extension if it is limited (most likely). If you are "hunched" forward, it limits the ability of the scapula to tilt posteriorly and prevent impingement. All the rowing and pulls in the world won't help if you don't have good thoracic spine mobility.

You need to gain extensibility in the coracoid muscles (pec minor, coracobrachialis, short head of biceps) and simultaneously gain strength in lower trap if the coracoid muscles are stiff. If they are short, you need prolonged stretching for 30 minutes, 6 times a day (not a typo) to add actual length. Figure 8 clavicle straps work well here as does active correction of posture for extended periods (this part sucks BTW...very challenging).

Have the ART guy work on the coracoid muscles, rhomboids, and levator scapula. They downwardly rotate the scapula. You need upward rotation.

You most likely have some pelvic issues that are feeding this scenario as well. Probably anterior tightness. Have 'em check and help you with a corrective program.

Just stretching won't help. You need to improve extensibility on one side (the front) and increase stiffness on the back side.

Hope that helps a bit.

Bill

[kinney1]

Wow, thanks for the post Bill. You are right on the money with pelvis/anterior tightness. That is included in my corrective program from my PT, but it is pretty remarkable that you even mentioned that without examining me in person.....I will ask for my next ART session to hit on the coracoid muscles, rhomboids, and levator scapula....Between work and my family there is no way I can stretch 6 times a day for 30 minutes. Is there any exercises I can do to gain "extensibly in the coracoid muscles" as you suggest . Or anything else you can recommend to a relative novice for improving my "thoracic spine mobility"? Thanks for your time and patience with my posts!

[Bill Hartman]

Originally Posted by kinney1

Wow, thanks for the post Bill. You are right on the money with pelvis/anterior tightness. That is included in my corrective program from my PT, but it is pretty remarkable that you even mentioned that without examining me in person.....I will ask for my next ART session to hit on the coracoid muscles, rhomboids, and levator scapula....Between work and my family there is no way I can stretch 6 times a day for 30 minutes. Is there any exercises I can do to gain "extensibly in the coracoid muscles" as you suggest . Or anything else you can recommend to a relative novice for improving my "thoracic spine mobility"? Thanks for your time and patience with my posts!

You may be missing my point on the prolonged stretching. Basically, you hold yourself in the corrected position as much as possible (this is the challenging part as you get distracted by brain activities). For instance, if you're working at a desk, you assume the corrected posture to the best of your ability by activating the lower trap and scapular depressors. This keeps the short muscles on under constant tension and encourages the actual lengthening that typical stretching can't touch. Your health pro team should be able to help you with cues to achieve the corrected posture. If they can't, fire them.

Buy a foam roller to mobilize your spine and follow it with spinal extension and rotation/sidebending exercises (again ask your health pro team for guidance) to increase mobility. Then like your mom always said, "Sit up straight young man!"

Bill

[kinney1]

I understand the "stretching" suggestion now, thanks Bill!...The PT's that I am seeing are very helpful and knowledgeable, and this gives me some more ideas to help correct the problem.