Distal biceps tendon tendinitis

What is Distal biceps tendon tendinitis

Distal biceps tendon tendinitis is inflammation of the distal biceps tendon. The distal biceps tendon is a strong cord of tissue that connects the biceps muscle, on the front of the upper arm, to a bone (radius) in the elbow.

Distal biceps tendon tendinitis can interfere with the ability to bend the elbow and turn the hand palm-up (supination). This condition is usually caused by overusing the elbow joint and the biceps muscle, and it usually heals within 6 weeks.

Distal biceps tendon tendinitis may include a grade 1 or grade 2 strain of the tendon. A grade 1 strain is mild, and it involves a slight pull of the tendon without any stretching or noticeable tearing of the tendon. There is usually no loss of biceps muscle strength. A grade 2 strain is moderate, and it involves a small tear in the tendon. The tendon is stretched, and biceps muscle strength is usually decreased.

What are the causes?

This condition may be caused by:

  • A sudden increase in the frequency or intensity of activity that involves the elbow and the biceps muscle.
  • Overuse of the biceps muscle. This can happen when you do the same movements over and over, such as:
    • Supination.
    • Forceful straightening (hyperextension) of the elbow.
    • Bending of the elbow.
  • A direct, forceful hit or injury (trauma) to the elbow. This is rare.

What increases the risk?

The following factors may make you more likely to develop this condition:

  • Playing contact sports.
  • Playing sports that involve throwing and overhead movements, including racket sports, gymnastics, weight lifting, or bodybuilding.
  • Doing physical labor.
  • Having poor strength and flexibility of the arm and shoulder.
  • Having injured other parts of the elbow.

What are the signs or symptoms?

Symptoms of this condition may include:

  • Pain and inflammation in the front of the elbow. Pain may get worse during certain movements, such as:
    • Supination.
    • Bending the elbow.
    • Lifting or carrying objects.
    • Throwing.
  • A feeling of warmth in the front of the elbow.
  • A crackling sound (crepitation) when you move or touch the elbow or the upper arm.

In some cases, symptoms may return (recur) after treatment, and they may be long-lasting (chronic).

How is this diagnosed?

This condition is diagnosed based on your symptoms, your medical history, and a physical exam. You may have tests, including X-rays or MRIs. Your health care provider may test your range of motion by having you do arm movements.

How is this treated?

This condition is treated by resting and icing the injured area, and by doing physical therapy exercises. Depending on the severity of your condition, treatment may also include:

  • Medicines to help relieve pain and inflammation.
  • Ultrasound therapy. This is the application of sound waves to the injured area.

Follow these instructions at home:

Managing pain, stiffness, and swelling

  • If directed, put ice on the injured area:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your fingers often to avoid stiffness and to lessen swelling.
  • Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

If directed, apply heat to the affected area before you exercise. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.

  • Place a towel between your skin and the heat source.
  • Leave the heat on for 20–30 minutes.
  • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Do notlift anything that is heavier than 10 lb (4.5 kg) until your health care provider tells you that it is safe.
  • Avoid activities that cause pain or make your condition worse.
  • Do exercises as told by your health care provider.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do notdrive or operate heavy machinery while taking prescription pain medicines.
  • Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

  • Warm up and stretch before being active.
  • Cool down and stretch after being active.
  • Give your body time to rest between periods of activity.
  • Make sure to use equipment that fits you.
  • Be safe and responsible while being active to avoid falls.
  • Do at least 150 minutes of moderate-intensity exercise each week, such as brisk walking or water aerobics.
  • Maintain physical fitness, including:
    • Strength.
    • Flexibility.
    • Cardiovascular fitness.
    • Endurance.

Contact a health care provider if:

  • You have symptoms that get worse or do not get better after 2 weeks of treatment.
  • You develop new symptoms.

Get help right away if:

  • You develop severe pain.

Biceps Tendon Tendinitis (Distal) Rehab

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your arm. These exercises can also help to relieve pain and stiffness.

Exercise A: Supination, active-assisted

  1. Stand or sit with your left / right elbow bent to an “L” shape (90 degrees).
  2. Rotate your palm up until you cannot rotate it anymore. Then, use your other hand to help rotate your left / right forearm more.
  3. Hold this position for __________ seconds.
  4. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Pronation, active-assisted

  1. Stand or sit with your left / right elbow bent to an “L” shape (90 degrees).
  2. Rotate your left / right palm down until you cannot rotate it anymore. Then, use your other hand to help rotate your left / right forearm more.
  3. Hold this position for __________ seconds.
  4. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your arm and shoulder. Endurance is the ability to use your muscles for a long time, even after your muscles get tired.

Exercise C: Supination

  1. Sit with your left / right forearm supported on a table. Your elbow should be at waist height.
  2. Rest your hand over the edge of the table, palm-down.
  3. Gently grasp a lightweight hammer near the head. As this exercise gets easier for you, try holding the hammer farther down the handle.
  4. Without moving your elbow, slowly rotate your palm up so it faces the ceiling.
  5. Hold this position for__________ seconds.
  6. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Pronation

  1. Sit with your left / right forearm supported on a table. Your elbow should be at waist height.
  2. Rest your hand over the edge of the table, palm-up.
  3. Gently grasp a lightweight hammer near the head. As this exercise gets easier for you, try holding the hammer farther down the handle.
  4. Without moving your elbow, slowly rotate your palm down.
  5. Hold this position for __________ seconds.
  6. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Elbow flexion, supinated

  1. Sit on a stable chair without armrests, or stand.
  2. If directed, hold a __________ weight in your left / right hand, or hold an exercise band with both hands. Your palms should face up toward the ceiling at the starting position.
  3. Bend your left / right elbow and move your hand up toward your shoulder. Keep your other arm straight down, in the starting position.
  4. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise F: Elbow extension

  1. Lie on your back.
  2. Hold a __________ weight in your left / right hand.
  3. Bend your left / right elbow to an “L” shape (90 degrees) so your elbow is pointed up to the ceiling and the weight is overhead.
  4. Straighten your elbow, raising your hand toward the ceiling. Use your other hand to support your left / right upper arm and to keep it still.
  5. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

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