(Golden Oldie) Biceps disorder rehabilitation for the athlete: a continuum of moderate- to high-load exercises

Review written by Dr Teddy Willsey info

Key Points

  1. The long head of the biceps tendon is considered intra-articular to the glenohumeral joint and is thought to play an important role in shoulder stability.
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BACKGROUND & OBJECTIVE

Anterior shoulder pain in overhead throwing athletes is oftentimes accompanied by involvement of the long head of the biceps tendon (LHBT). The LHBT originates from the glenoid labrum and supraglenoid tubercle. It is considered intra-articular to the glenohumeral joint (GHJ), although it has its own separate synovial sheath fibers distinct from the capsular fibers of the GHJ (2).

The LHBT’s ultimate role in GHJ stability is not fully understood. It is thought to provide humeral depression and resist both anterior and inferior translation (3). LHBT pathology is typically accompanied by SLAP lesions, rotator cuff pathology, or internal impingement and rarely seen in isolation (4). Physical findings of glenohumeral internal rotation deficit (GIRD) and scapular dyskinesia may play a role in the development of LHBT pathology and associated shoulder pathology as well (5).

Non-operative and post-operative treatment for LHBT pathology associated conditions involves progressively increasing biceps load via exercise prescription. Previous EMG shoulder research has failed to identify exercises that target moderate to high biceps brachii (BB) activation. The aim of this study was to examine EMG activity of the BB with the goal of building a continuum of exercises to be used in the later phases of shoulder rehabilitation for overhead throwing athletes.

Long head of biceps pathology is typically accompanied by SLAP lesions, rotator cuff pathology, or internal impingement and rarely seen in isolation.
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This study should provide clinicians with a framework to either avoid or encourage biceps activity for patients with LHBT pathology and prescribe exercises with greater precision.

METHODS

  • 30 healthy volunteers were recruited: average age 23, 15 men, 15 women.
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