Can't Figure Out What's Wrong With My Shoulder/Bicep??

[Sauce-head]

Hey all,

Well this has been an eventful year in terms of injuries for me. Was hitting chest at the gym about 6 months ago now when i noticed a sharp pain in my left shoulder (was doing moderately heavy flat dumbell presses). It literally felt like someone was stabbing me in front of my shoulder.

I started seeing a PT and got diagnosed with the dreaded shoulder impingment syndrome. Started rehabbing 3x a week with the common RC exercises; internal, external rotations along with electronic stimulation and icing. My PT told me to simply continue to rehab my shoulder and I can still work out; would be good as new in no time.

After about 6 weeks of seeing him I noticed the pain had definitely gone down quite a bit and was deemed ready to get back in the gym full force. Started working out again and within a few weeks, a started to develop pain in my bicep; right at the bend of my elbow.

From my research I'm aware that bicep issues usually accompany shoulder issues, especially with the RC.

So I started seeing a specialist; who swears by ART (Active Release Therapy). He determined that I had pretty severe scar tissue build up in my bicep through doing Graston on my arm and started me on strength and stability rehab and immediately told me to stop going to the gym.

I took 6 weeks off from the gym and rehabbed with core training (presumably for my posture and shoulder strengthening) and then was given permission to start going back to the gym. I went light for the first couple weeks, then worked my way back to moderately heavy weight. Guess what?? The pain in my bicep was still very present.

I've become incredibly frustrated and after more research I'm starting to think I may have tendinosis of my bicep rather than tendonitis. I've tried icing (doesn't really help) and wall strecthing (helped some); but the pain is just nagging.

Currently my symptoms are:

- noticable "crack" in my shoulder when I lift my arm over-head
- pain in my neck on the same side as the shoudler/bicep pain
-pain discomfort in the bicep especially at the inner bend of my elbow


I read a great article on eccentric exercises for rehabbing bicep tendinosis and I'm thinking of giving that a shot. But I just wanted to get your guys thoughts on what might be going on.

I've religously worked my RC's since the original diagnosis and the "stabbing" pain I felt in my shoulder is gone; although its still not as strong as my other side.

I feel fairly certain that I was mis-diagnosed with impingement when in fact I was/am suffering from bicep tendinosis.

I did a couple sets of extremely light curls a couple days ago at the gym (5 lbs) and the next day my bicep was hurting a little more than normal.

The pain is pretty constant; meaning I can feel it through-out the day regardless of if I hit the gym or not.

I had just taken two weeks completely away from the gym and returned this week.

I've researched and posted in the Shoulder RC thread without much help.



Thanks for reading and any advice is very welcome.



SH

[addaminsane]

i had a similar issue with my shoulder that resulted from doing alot of dips. I tried rehabbing and it never worked.

After taking a while off (over three months) i went back and it was alot better. It still bothers me on days that i do high reps, so i have to limit the amount of exercises per day that effect the area when i'm doing more than 6 reps per set.

The only way to permanently relieve these issues seems to be surgery... i have a friend who had a similar issue that resulted from him taking roids and going up to high in bench. He had surgery on his rc and is back to normal. The doctor said his rc is actually stronger now.

[braindx]

First off, loved your RH posts. I know that was a while ago though.

Hey all,

Well this has been an eventful year in terms of injuries for me. Was hitting chest at the gym about 6 months ago now when i noticed a sharp pain in my left shoulder (was doing moderately heavy flat dumbell presses). It literally felt like someone was stabbing me in front of my shoulder.

I started seeing a PT and got diagnosed with the dreaded shoulder impingment syndrome. Started rehabbing 3x a week with the common RC exercises; internal, external rotations along with electronic stimulation and icing. My PT told me to simply continue to rehab my shoulder and I can still work out; would be good as new in no time.

Can't be too sure but pain in front of the shoulder may mean long head biceps tendon rather than impingement.

Impingement is usually located on the SIDE/lateral aspect of the shoulder and doesn't manifest itself on the direct front. Although if the pain is up against the acromion it could be either.

After about 6 weeks of seeing him I noticed the pain had definitely gone down quite a bit and was deemed ready to get back in the gym full force. Started working out again and within a few weeks, a started to develop pain in my bicep; right at the bend of my elbow.

From my research I'm aware that bicep issues usually accompany shoulder issues, especially with the RC.

True or the time off could have healed your long head biceps, but getting back into exercise could've aggravated the other side of the biceps tendon.

So I started seeing a specialist; who swears by ART (Active Release Therapy). He determined that I had pretty severe scar tissue build up in my bicep through doing Graston on my arm and started me on strength and stability rehab and immediately told me to stop going to the gym.

I took 6 weeks off from the gym and rehabbed with core training (presumably for my posture and shoulder strengthening) and then was given permission to start going back to the gym. I went light for the first couple weeks, then worked my way back to moderately heavy weight. Guess what?? The pain in my bicep was still very present.

I bet..

The massage needs to be continued to loosen up everything. If you can poke around in your biceps, and feel tightness/tender spots and adheions in it that means you still have work to do.

Of course a professional is always better but you can do it yourself too.

I've become incredibly frustrated and after more research I'm starting to think I may have tendinosis of my bicep rather than tendonitis. I've tried icing (doesn't really help) and wall strecthing (helped some); but the pain is just nagging.

It's definitely chronic. No doubt about it. Anything that lasts longer than about a month can be trickier to get rid of.

Currently my symptoms are:

- noticable "crack" in my shoulder when I lift my arm over-head
- pain in my neck on the same side as the shoudler/bicep pain
-pain discomfort in the bicep especially at the inner bend of my elbow

I read a great article on eccentric exercises for rehabbing bicep tendinosis and I'm thinking of giving that a shot. But I just wanted to get your guys thoughts on what might be going on.

Yes, eccentrics will help. But they need to be very light to avoid aggravating. If it's that bad right now I wouldn't even be doing eccentrics.

I've religously worked my RC's since the original diagnosis and the "stabbing" pain I felt in my shoulder is gone; although its still not as strong as my other side.

I feel fairly certain that I was mis-diagnosed with impingement when in fact I was/am suffering from bicep tendinosis.

I did a couple sets of extremely light curls a couple days ago at the gym (5 lbs) and the next day my bicep was hurting a little more than normal.

The pain is pretty constant; meaning I can feel it through-out the day regardless of if I hit the gym or not.

I had just taken two weeks completely away from the gym and returned this week.

I've researched and posted in the Shoulder RC thread without much help.

Thanks for reading and any advice is very welcome.

SH

Okay, well, here's what you need to do.

First, read this tendonitis protocol (damn site is down right now so you may have to wait maybe until tomorrow until my friend can get it back up):

http://www.eatmoveimprove.com/2009/08/on-tendonitis/

This outlines pretty much all you should be doing for it.

The gist of it to get you start right now is:

1. Reduce inflammation and pain through use of fish oil (3-5g EPA+DHA or more... I've seen recommendations of .5g/10 lbs but you need to make sure you're getting enough vitamin K because fish oil thins the platelets in the blood) and potentiall NSAIDs as well.

Although tendonosis is a chronic degenerative tendonitis.... pain does mean there is inflammation which needs to be limited and eliminated first.

2. Rest. Obviously.

3. Self massage is absolutely critical. I would start from the neck and loosen up everything from there all the way dow to your wrist.

Pay attention to any tender/tight spots and make note of them and post here. Can be anywhere. Loosen them up aggressively.

I find it works best to put the muscle into shortest range of motion possible and then massaging it to loosen it up. Muscles don't like to loosen when they're contracted too much.

4. Avoid eccentrics for now. As even light weights are aggravating them.

5. Focus on correctin your posture if you have any deficiencies there.

6. Add in some joint supps if you haven't already. Glucosamine and chondroitin sulfate, MSM, cissus, etc. Your mileage my vary depending on how your body likes them. For some people it doesn't work. For others, it's great.

Basically, first off we are going to aim to loosen up everything and get inflammation and pain down. From there, the true rehab can be begin.


BTW, great post here. It's always easier to help people when they do their research, and provide excellent descriptions.

I'll let you know when the site is back up.

[Sauce-head]

First off, loved your RH posts. I know that was a while ago though.

Hahaha!! Thanks bro, hopefully they've been helpful for you. Its crazy how many guys grow up not having a clue and the girls seem to be born with it... gotta fight back! LOL

Can't be too sure but pain in front of the shoulder may mean long head biceps tendon rather than impingement.

Well initially the front of the shoulder was where the pain was... after rehabbing and strengthening my RC I don't have any pain in the front of my shoulder. It use to be tender when I poked at it when the pain first started and isn't any longer.

I'm having more of an issue on the left side of my neck running to the back of my neck/upper trap area as well as the tenderness in my bicep and bend at the elbow.

In fact as I sit here and type this my left bicep feels "heavy" if that makes sense. I definitely know I still have quite a bit of scar tissue build up there.

Impingement is usually located on the SIDE/lateral aspect of the shoulder and doesn't manifest itself on the direct front. Although if the pain is up against the acromion it could be either.

When I lift my arm up from the side to the side of my head I hear the "crack."

When I extend my arm straight out away from my body and then lift it over head (as if I'm raising my arm to ask a question) there is no crack, but some discomfort.


True or the time off could have healed your long head biceps, but getting back into exercise could've aggravated the other side of the biceps tendon.

Good point; I've been thinking along the same lines; secondary injury from over-compensating perhaps??



I bet..

The massage needs to be continued to loosen up everything. If you can poke around in your biceps, and feel tightness/tender spots and adheions in it that means you still have work to do.

Yeah bro, there is quiet a bit of tightness in the bicep.

Of course a professional is always better but you can do it yourself too.

Question about the massage; I know you mentioned not to have the arm bent or in a shorter ROM when doing the massage. Would laying my forearm on the table, palms up be a good position to have my arm in while resting for the massage? Would it help to use Icy-Hot or a Sports Cream??

I've heard conflicting things about Ice and Heat....


It's definitely chronic. No doubt about it. Anything that lasts longer than about a month can be trickier to get rid of.

Yeah I'm thinking of getting an MRI here just to make sure I don't have a tear of some sort...


Yes, eccentrics will help. But they need to be very light to avoid aggravating. If it's that bad right now I wouldn't even be doing eccentrics.

Good call; as much as I hate being out of the gym and losing size, I'd rather not go back til I'm 100%.

Would it be okay to still do legs?? I feel like I'll go crazy if I don't do any type of exercise! haha


Okay, well, here's what you need to do.

First, read this tendonitis protocol (damn site is down right now so you may have to wait maybe until tomorrow until my friend can get it back up):

http://www.eatmoveimprove.com/2009/08/on-tendonitis/

This outlines pretty much all you should be doing for it.

The gist of it to get you start right now is:

1. Reduce inflammation and pain through use of fish oil (3-5g EPA+DHA or more... I've seen recommendations of .5g/10 lbs but you need to make sure you're getting enough vitamin K because fish oil thins the platelets in the blood) and potentiall NSAIDs as well.

Interesting I had been taking Flax and coincidentally just switched over to Cod Liver Oil yesterday. Been taking 4.5g (one teaspoon) a day. Regarding Vitamin K, would it be necessary to supplement with it? Or could I simply get it through diet?

Although tendonosis is a chronic degenerative tendonitis.... pain does mean there is inflammation which needs to be limited and eliminated first.

I know its hard to tell without seeing me; but what do you believe I'm dealing with?? I think at least knowing what I have would make me feel a lot better? I personally feel like I have bicep tendinosis. I've always had a separate day where I trained biceps as well as doing forearm work 2-3x a week. Additionally I've been working a desk job for the past year sitting on the computer all day.

2. Rest. Obviously.

Ice'd and massaged a bit today and it helped.


3. Self massage is absolutely critical. I would start from the neck and loosen up everything from there all the way dow to your wrist.

Pay attention to any tender/tight spots and make note of them and post here. Can be anywhere. Loosen them up aggressively.

What sort of pressure should I use when massaging? Also is there a particular techinque to the massage?

I find it works best to put the muscle into shortest range of motion possible and then massaging it to loosen it up. Muscles don't like to loosen when they're contracted too much.

Let me know what position is optimal for massaging my arm.

4. Avoid eccentrics for now. As even light weights are aggravating them.

5. Focus on correctin your posture if you have any deficiencies there.

I definitely have an issue with this; posture is very important to me; but my shoulders grow very quickly and I think its really rounded my shoulders a lot.

6. Add in some joint supps if you haven't already. Glucosamine and chondroitin sulfate, MSM, cissus, etc. Your mileage my vary depending on how your body likes them. For some people it doesn't work. For others, it's great.

I've got som Gluc/Chon with MSM; 1500mg of Gluc Sulfate and 1200mg of Chon Sulfate per 3 pills. Is there a certain dosage I should be taking???

Also what's your thoughts on Cissus?? Would it help in my situation or is it strictly more about the person rather than the injury?

Basically, first off we are going to aim to loosen up everything and get inflammation and pain down. From there, the true rehab can be begin.

Makes sense; I've read so much on tendonitis and tendinosis so I've been rather confused. Felt maybe I didn't have inflammation and just needed strict rehab?? But your right; I've got scar tissue build up and need to get the pain to subside first.

BTW, great post here. It's always easier to help people when they do their research, and provide excellent descriptions.


I'll let you know when the site is back up.

Sounds good!!

Thanks again; looking forward to your answers; have a Happy New Year!!1







SH

[braindx]

Well initially the front of the shoulder was where the pain was... after rehabbing and strengthening my RC I don't have any pain in the front of my shoulder. It use to be tender when I poked at it when the pain first started and isn't any longer.

I'm having more of an issue on the left side of my neck running to the back of my neck/upper trap area as well as the tenderness in my bicep and bend at the elbow.

In fact as I sit here and type this my left bicep feels "heavy" if that makes sense. I definitely know I still have quite a bit of scar tissue build up there.

Yeah, probably tightness all the way from the neck down to the wrist.

That's why I want you getting massaged from up there all the way down to the wrist. Loosen everything up and hopefully prevent neurological symptoms as well.

Add in some nerve glides and see if they help a bit too:
http://www.handhealthresources.com/S.../Exercises.htm

Question about the massage; I know you mentioned not to have the arm bent or in a shorter ROM when doing the massage. Would laying my forearm on the table, palms up be a good position to have my arm in while resting for the massage? Would it help to use Icy-Hot or a Sports Cream??

I've heard conflicting things about Ice and Heat....

Generally, heat for muscles if there's no swelling or non-acute. Yours probably doesn't have either, and heat will be useful for helping loosen up the muscles.

Thus, heat to help loosen stuff up, and then hit it with the soft tissue massage.

For the massage I'd say lean forward on a desk with your UPPER arm on the desk and bent your elbow so that your hand is sitting on your head or shoulder if possible. Then with your other arm DIG into your biceps and work out all of the tender spots.

Make sure to hit up the brachialis, brachioradialis, and coracobrachialis.. and not just biceps brachii. It's likely you will have tender/painful trigger points in all of them.

Generally, with ice you want it on joint/ligament/tendon injuries IF it helps. If it's acute then you use it as well within RICE scheme. Muscles most of the time won't get ice.

In your case, you may want to put some ice on your tendon, and heat on the muscle if it works well that way. Although I suspect your tight elbow flexors are to blame for your tendonitis in both sides of the shoulder.

Yeah I'm thinking of getting an MRI here just to make sure I don't have a tear of some sort...

Yep, that's up to you. If you have insurance that'll pay for it with a low copay why not?

Good call; as much as I hate being out of the gym and losing size, I'd rather not go back til I'm 100%.

Would it be okay to still do legs?? I feel like I'll go crazy if I don't do any type of exercise! haha

Go for it. I would tend to say you can even do arm/shoulder work if it doesn't aggravate it as well, but since it's a chronic injury it's best to play upper body on the safe side and just avoid it for now.

Interesting I had been taking Flax and coincidentally just switched over to Cod Liver Oil yesterday. Been taking 4.5g (one teaspoon) a day. Regarding Vitamin K, would it be necessary to supplement with it? Or could I simply get it through diet?

I know brocolli has a lot. You can probably do it through diet.

Fish oil is better than CLO though for the anti-inflammatory effects. Specifically you want the combined EPA+DHA to be at least 3-5g like I said or even up to the .5g/10 lbs body mass.

I know its hard to tell without seeing me; but what do you believe I'm dealing with?? I think at least knowing what I have would make me feel a lot better? I personally feel like I have bicep tendinosis. I've always had a separate day where I trained biceps as well as doing forearm work 2-3x a week. Additionally I've been working a desk job for the past year sitting on the computer all day.

Yeah, I'm pretty sure about the details you've given me.

Now that you mention that you do a lot of forearm work I do think the massage to the forearms as well to loosen those up + the nerve glides will also benefit you greatly. Very tight forearm flexors also cause residual bicipetal tightness as well from all I've seen.

What sort of pressure should I use when massaging? Also is there a particular techinque to the massage?

Cross friction and myofascial tend to work well. Use both in your arsenal.

Start light. If it helps keep going with that. But you're probably going to have to dig in to get particularly hard to loosen up spots. Make sure every couple of minutes that you shake out your arms, or extend then to see the effectiveness of what you've been doing.

You'll get the hang of it pretty quickly.

Let me know what position is optimal for massaging my arm.

Stated above. With the forearm what I would is flex your wrist and then push it up against something so it stays there with your flexors relaxed. Then with the other arm dig into it. You'll probably have a bunch of tender spots up near the center elbow and probably medial epicondyle as well.

I've got som Gluc/Chon with MSM; 1500mg of Gluc Sulfate and 1200mg of Chon Sulfate per 3 pills. Is there a certain dosage I should be taking???

Also what's your thoughts on Cissus?? Would it help in my situation or is it strictly more about the person rather than the injury?

3:2 ratio is supposedly optimal. I'm not sure about the dosing. I'd go with whatever it says on the package it came in. If that doesn't help a lot then maybe increase it a bit.

Most joint/tendon/ligament supplements are highly dependent upon the person. If you don't see any help with one you can try another if you have the money. Otherwise, don't bother. It may help especially in chronic cases though.

Makes sense; I've read so much on tendonitis and tendinosis so I've been rather confused. Felt maybe I didn't have inflammation and just needed strict rehab?? But your right; I've got scar tissue build up and need to get the pain to subside first.

Well, if the site wasn't down until jan 3rd my article would be very informative for you. You'll probably just have to wait a bit until we can get it back up.

In a couple of days:
http://www.eatmoveimprove.com/2009/08/on-tendonitis/

[robc6]

check these articles out, they are very good. your best having a MRI or Ultrasound first to diagnose your problem accurately.

replace *** with www

***.bodybuilding.com/fun/drryan13.htm
***.bodybuilding.com/fun/drryan9.htm

[Sauce-head]

braindx: Hey bro just wanted to give you an update:

Have been out of the gym for the past 4 days and started doing self massage 1-2x a day for the past couple days followed by 20-35 minutes of ice on the tendon at the bend of my elbow and on the front of my shoulder, upper pec.

I've also been taking Cod Liver Oil (I'll get Fish Oil when this runs out, but it actually has 3g of EPA and 4g of DHA and been on Gluc/Chond with MSM.

------------------------------------------------------------------

What I've noticed with the massage: The bicep as mentioned has A LOT of scar tissue. When my ART therapist did Graston on it initially the whole bicep looked like a giant bruise from all the busted blood vessels.

Its pretty sore on the high point of my bicep and right at the inner bend of the elbow. When I'm massaging the bicep area I feel the top of the tendon in my shoulder (start of the bicep tendon) causing some discomfort. Overall impression of the bicep area is very tight and I definitely have a lot of work to do to get it out.

When massaging my forearm area I don't feel much pain or discomfort, nonetheless I continue to go from the side of my neck all the way to the wrist.

I'll incorporate the nerve gliding into my routine today.



EDIT: the website is still down...


SH

[Sauce-head]

check these articles out, they are very good. your best having a MRI or Ultrasound first to diagnose your problem accurately.

replace *** with www

***.bodybuilding.com/fun/drryan13.htm
***.bodybuilding.com/fun/drryan9.htm

Cool bro, I'll check those out... thx for the link.

I agree, I hope I'm not dealing with a tear since my first PT told me all I had was impingment and I could keep working out as normal. Although I'd suspect if I did have a tear that it probably would hurt A LOT more than it does....





SH

[braindx]

braindx: Hey bro just wanted to give you an update:

Have been out of the gym for the past 4 days and started doing self massage 1-2x a day for the past couple days followed by 20-35 minutes of ice on the tendon at the bend of my elbow and on the front of my shoulder, upper pec.

I've also been taking Cod Liver Oil (I'll get Fish Oil when this runs out, but it actually has 3g of EPA and 4g of DHA and been on Gluc/Chond with MSM.

------------------------------------------------------------------

What I've noticed with the massage: The bicep as mentioned has A LOT of scar tissue. When my ART therapist did Graston on it initially the whole bicep looked like a giant bruise from all the busted blood vessels.

Its pretty sore on the high point of my bicep and right at the inner bend of the elbow. When I'm massaging the bicep area I feel the top of the tendon in my shoulder (start of the bicep tendon) causing some discomfort. Overall impression of the bicep area is very tight and I definitely have a lot of work to do to get it out.

When massaging my forearm area I don't feel much pain or discomfort, nonetheless I continue to go from the side of my neck all the way to the wrist.

I'll incorporate the nerve gliding into my routine today.



EDIT: the website is still down...


SH

Sounds good. Take a day or two off massage every couple days. Let your tissue heal without beating them up more.

Sleep A LOT. Get a lot of good nutrition. Will significant speed healing.

Don't ice so much. 10-15 minutes max per session.

You may also want to try heat as well to see if it helps more. Heat before massage will probably help a lot as well.

Everything else looks pretty good. You should see improvements soon if not already.


Site will be up tomorrow. Guaranteed. Unless my friend who is fixing it gets his flight delayed (to where the server is which went out because of a power failure).

[Sauce-head]

Sounds good. Take a day or two off massage every couple days. Let your tissue heal without beating them up more.

Sleep A LOT. Get a lot of good nutrition. Will significant speed healing.

Don't ice so much. 10-15 minutes max per session.

You may also want to try heat as well to see if it helps more. Heat before massage will probably help a lot as well.

Everything else looks pretty good. You should see improvements soon if not already.


Site will be up tomorrow. Guaranteed. Unless my friend who is fixing it gets his flight delayed (to where the server is which went out because of a power failure).

The site was up yesterday, so got some good reading in. Although I'd be lying if I said I wasn't a bit confused with all the info! Also read Dr. Ryan's articles which were informative and helpful.

---------------------------------------------------------------------------

Took a day off massaging yesterday.


Back at it today, the things I notice are:

-Any time I'm massaging my bicep I feel discomfort at the head of the tendon in my shoulder. Neck soreness has improved A LOT and I'm thinking that was probably caused by something else I did in the gym the week prior.

-Still have noticable soreness in my left trap, supraspinatus area..

-Been taking the Cod Liver Oil and Gluc/Chond with MSM, probably too early too tell if its working and I've been out of the gym for a week so don't know if the pain has subsided because of one or the other, or both.

-The head of my bicep gets sore pretty quick with the massage as I'm really digging in there to try and clear up the scar tissue. I know when my recent therapist did Graston, my arm light up like a Christmas tree. Should I expect to see redness or any broken blood vessels in the area??

Lastly, how long do you feel that I should stick to heat, massage and ice before I get back in the gym to try some eccentrics? I realize it mostly depends on how I'm doing, and I don't want to rush the healing process, I just want to get better in the WORST WAY!!! Going crazy without the gym.


Thanks bro,


SH

[braindx]

The site was up yesterday, so got some good reading in. Although I'd be lying if I said I wasn't a bit confused with all the info! Also read Dr. Ryan's articles which were informative and helpful.

---------------------------------------------------------------------------

Took a day off massaging yesterday.


Back at it today, the things I notice are:

-Any time I'm massaging my bicep I feel discomfort at the head of the tendon in my shoulder. Neck soreness has improved A LOT and I'm thinking that was probably caused by something else I did in the gym the week prior.

-Still have noticable soreness in my left trap, supraspinatus area..

-Been taking the Cod Liver Oil and Gluc/Chond with MSM, probably too early too tell if its working and I've been out of the gym for a week so don't know if the pain has subsided because of one or the other, or both.

-The head of my bicep gets sore pretty quick with the massage as I'm really digging in there to try and clear up the scar tissue. I know when my recent therapist did Graston, my arm light up like a Christmas tree. Should I expect to see redness or any broken blood vessels in the area??

Lastly, how long do you feel that I should stick to heat, massage and ice before I get back in the gym to try some eccentrics? I realize it mostly depends on how I'm doing, and I don't want to rush the healing process, I just want to get better in the WORST WAY!!! Going crazy without the gym.


Thanks bro,


SH

1. Yeah, if there's tension in your biceps and it tightens then it will pull on the insertion of the biceps tendon to the superior labrum.

Don't kill yourself with the massage. Remember to take some days off and just let it heal. Use heat.

Ultimately your goal is to ge the biceps back to normal length free of scar tissue so it doesn't pull on your long head or the insertion and aggravate it.

2. Hit that area with heat and massage too.

3. CLO is OK. Doesn't have enough EPA+DHA (that's the main stuff you want from fish oil which is anti-inflammatory omega 3) but it has lots of other good stuff as well.

The rest I would only use if it helps. We'll see.

4. Don't go too hard. Graston is pretty rough not gonna lie. With that he's gonna tear you up.

If it helps by loosening you up then it's good. If it's making your muscles tighten back up then it's generally not so good.

5. Make sure you are stretching afterwards.

Heat -> massage -> stretching is a good combo. Get the biceps lengthened and hopefully loosen. PNF (proprioceptive neuromuscular facilitation) stretching protocol works well.

[Sauce-head]

Made an appointment with an Accuputure doc over the weekend and went in this morning.

He used about 8 needles on my affected shoulder and bicep, then sprayed on a herb mix and hit it with heat for 20 minutes. Definitely "feels" good, shall see if it worth anything.

Took two days off massaging and hit it last night for a quick 15-20 minute session; I still feel quiet a bit of built up scar tissue in my bicep.

Gonna use heat and light massage tonight and follow it up with stretching along with supps. I haven't been so good on taking Gluc/Chond, need to be better about that. I'm popping pills like an addict....LOL

I'm going to see how I feel this weekend and hopefully get back in the gym soon doing eccentrics.




SH

[braindx]

Is it loosening up much at all? How's the shoulder been feeling?

Also, if your muscles are insanely tight and you know you're not getting enough magnesium, zinc and potassium from your diet you may want to supplement those as well. They should help with muscle relaxing.

I'd only keep taking gluc/chond if it's still helping. Otherwise, don't bother. Do you see any measurable effect of taking and or not taking it?

[Sauce-head]

Is it loosening up much at all? How's the shoulder been feeling?

Also, if your muscles are insanely tight and you know you're not getting enough magnesium, zinc and potassium from your diet you may want to supplement those as well. They should help with muscle relaxing.

I'd only keep taking gluc/chond if it's still helping. Otherwise, don't bother. Do you see any measurable effect of taking and or not taking it?

After Acupuncture yesterday it feels noticably looser. However there is still definitely some tightness in there. The neck pain has sub-sided noticably but interestingly enough I'm having some discomfort on the other side of my back at the middle of my back. Not sure if that's from the massaging I'm doing.

I've been very inconsistent with the Gluc/Chond MSM so to be honest I can't tell if its doing anything.

My shoulder feels pretty good, still hear the crackin' when I lift it up sideways over my head, but there isn't much pain at all. Just the slight neck discomfort and tightness in my bicep, which as I mentioned has gone down.

Do you think after this week I might be able to get back in the gym doing some eccentrics? Also I've started massaging in the shower, to let the heat hit the muscle to loosen it up, then massage it for 5 minutes and continue for another 10-15 once I get out.

Should I only be stretching out my bicep after the massage or are there other stretches that would help???


Thanks bro,


SH

[braindx]

After Acupuncture yesterday it feels noticably looser. However there is still definitely some tightness in there. The neck pain has sub-sided noticably but interestingly enough I'm having some discomfort on the other side of my back at the middle of my back. Not sure if that's from the massaging I'm doing.

Definitely hit up the other side if it's tight too.

My shoulder feels pretty good, still hear the crackin' when I lift it up sideways over my head, but there isn't much pain at all. Just the slight neck discomfort and tightness in my bicep, which as I mentioned has gone down.

Probably a good time to start adding in some mobility work.

Do some wall slides (youtube that) and some external and internal rotation stretches. YOu can use the doorway for the external rotation (arms at 90 degrees, hands pointing up at 90 degrees) and sleeper stretch for internal rotation.

Do you think after this week I might be able to get back in the gym doing some eccentrics?

Sounds good to me.

Also I've started massaging in the shower, to let the heat hit the muscle to loosen it up, then massage it for 5 minutes and continue for another 10-15 once I get out.

Should I only be stretching out my bicep after the massage or are there other stretches that would help???

Stretching can generally be done anytime.

[Sauce-head]

Wanted to update this thread:

Been continuing with massage therapy about 20 minutes a day and stretching.

--------------------------------

When I first started massaging my brachili area of the bicep was very very sore and felt "heavy."

I notice now it doesn't feel sore at all, not sure if this is my body getting use to the massage or if I've effectively broke down a good amount of scar tissue I had there.

I've also continued to see my Accuputure doc and his help has definitely helped my shoulder and bicep "feel" better, not sure if its actually healed anything yet.

I plan on seeing the accupture doc for another few weeks and then will get back in the gym doing eccentrics as phase one of rehab.

I still feel a dullness when I wake up in the morning and I know the area isn't 100% when compared to my right side.


Let me know what you think braindx






SH

[braindx]

Do you sleep on that shoulder or roll around?

That could be aggravating it some when that occurs.

Otherwise, looks like you are doing fairly well. It's only been about 2.5-3 weeks or so since you started... a lot of people with really bad biceps issues can often be in the physical therapy clinic for up to 2-3 months (well, if you torn it and got it repaired then you'd be in for like 8-12 months).

If the acupuntures working keep it up. Acupuncture/dry needling/etc. is great for restimulating inflammation for healing process.

Add in the eccentrics slow.

[Sauce-head]

Do you sleep on that shoulder or roll around?

That could be aggravating it some when that occurs.

Otherwise, looks like you are doing fairly well. It's only been about 2.5-3 weeks or so since you started... a lot of people with really bad biceps issues can often be in the physical therapy clinic for up to 2-3 months (well, if you torn it and got it repaired then you'd be in for like 8-12 months).

If the acupuntures working keep it up. Acupuncture/dry needling/etc. is great for restimulating inflammation for healing process.

Add in the eccentrics slow.

Good point, I rushed back into the gym before and it only set me back. I don't want to do anything to stop the progress. I'll continue with the massaging and supps before I head back to the gym even to do eccentrics.

Yeah I tend to roll from side to side a lot when I sleep. I've been making an effort to sleep on my back and fall asleep but its not that comfortable and I notice I'm always on one side when I wake up.

I have been kinda putting my arm to the side of me when I initially go to bed in an effort to avoid putting my body weight on it.

I'll update again in a few days.





SH

[Sauce-head]

Wanted to update this thread since so many others disappear into the abyss after some time.

I really started researching cross fiber and myofasical massage techniques this past weekend. I used what I presume is the most common cross fiber technique last night by bending my two middle fingers, my middle finger slightly lower than the finger to the right and had the index and pinkie fingers in a hang loose position.

First off this made a WORLD off difference in massaging. It shouldn't even be called massaging, it should be called "digging scar tissue" because nothing about it feels like a massage. Feels like a very light form of Graston to tell you the truth. But I'm happy, because I feel like I'll be making so good progress over the next month.

After realizing that I was not massaging the tissue deep enough for the past month, I have no plans to get back in the gym for at least another month. Sucks, but I'd rather get all this scar tissue out then start up at the gym only to stop again like I had been.

My brachilli is pretty sore today, which to me is the first sign of progress in forever! I'm still taking my Cod Liver Oil and Gluc/Chon with MSM combo. Should be finishing up the CLO in about 3 weeks or less and then I'll switch to Fish Oil as recommended looking for the highest concentration of EPA/DHA.

My diet has been very strict, eating tons of fish and lean proteins, staying low on carbs, mainly getting them through veggies.

I do have some questions for Braindx:


a) I know you mentioned Myofasical as another techinque and I watched some youtube videos on them last night; but I'm wondering how I can do myofasical on myself? Looks like you need two hands to really dig in to the main area (bicep) and the surrounding areas? Should I have a friend or preferably a hot @ss girl do this to me? haha

b) I remember when I got Graston done there was an incredible amount of broken blood vessels in the area after and it was very sore. I realize now the whole issue is lack of blood flow to the area and that was a good thing. While I don't have severe bruising I do I soreness and a slight redness to the area today. I used a warm compress after for about 5 minutes in hopes it will start to stimulate blood flow and break up the scar tissue. Is this thinking correct?

c) Are there any other stretches you recommend I do after the massage? I've been doing the classic bicep stretch. I know you mentioned the wall stretch, which I will start to incorporate as well.

d) Also should I ice to combat the soreness? Reason I ask is I know our goal here was to create inflammation to effectively break up the scar tissue.

d) This isn't a question, just a comment; I feel positive now that any other discomfort I'm getting especially in my neck and upper trap area is being caused by the scar tissue build up in my bicep. From all my research it indicated that a lack of blood flow to an area will definitely cause posture issues and discomfort in the surrounding areas. Any thoughts on this?


Thanks for your help bro, and I feel really confident now that I will be able to get rid of this mature mature scar tissue and get back in the gym at some point.





SH

[braindx]

Yeah, I guess I should have outlined what kind of massaging to do earlier (although I thought I put it in the tendonitis article).

In general, cross friction tends to have the best results especially if you put the muscle into short non-contracted range of motion. It MUST be deep cross friction to break up stuff. You can't do piddly stuff and expect good results quickly.


A. For myofascial --

1. Squeeze your index and middle fingers against each other, and then pin your thumb against your index finger.

Put some lotion/massage cream on your thumb, and then exert deep pressure with your thumb along the muscle longitundinally.

Or you can have hot girls do it. Usually having someone else do it is better, but not if you can do it better yourself. There's very few people I've met who can actually do it better than myself (none that I wouldn't have to pay), so in general the best resource if you if you're educated. Unless the girl wants to learn.


B. Heat helps with blood flow, and loosening up muscles that are tight. Doesn't do anything specifically for scar tissue.

Soft tissue work is pretty much the only stuff that is going to break up the scar tissue unless you have such limited mobility that stretching will break up stuff. This is why massage is so important for high level athletes, and for those with significant injury conditions. Scar tissue jacks up everything.


C. That biceps stretch is fine if it works.

If you're having problems you should pronate your forearm and extend your shoulder as far as possible -- this will put the biceps in a pretty good stretch using any type of surface.

Another way you can do it is to exert pressure on the muscle, and lenghten and straighten it. This is another good way to break up stuff as well. Pressure helps put some tension into the muscle, and when you straighten it it will help break up stuff that inhibit the muscle from sliding properly + give you a decent stretch.


D. Ice helps with acute inflammation, yes. From massage possibly if you did a lot. If there's bursting blood vessels you may want to try it. Ice also makes the muscle contract/get tighter though so it may be a trade off.

Play around with it and see if it helps. Sometimes it does, sometimes it doesn't.


E. Yep. In general, most problems are due to:

1. improper biomechanics
2. poor posture
3. lack of mobility (including scar tissue)
4. muscle imbalances around the joints or referring joints

If you have crap posture, it will affect all of the other 3. Same with lack of mobility with your biceps as you are finding out.

Basically, deep tissue massage everything from the neck to your wrist (need a partner for this one). Around the scapula, RC tendons, neck, rhomboids, triceps/biceps/etc. and you will feel much better. Obviously, it helps to have someone (girl preferably) who knows anatomy.... in both ways.

[Finnegan Bell]

Bro ,you are totally obsessed! Like me! I bit u keep on testing the painful movements to see if u got better ! every hour ! And this is aggravating it more! Guess what ,some of the treating options may help it or may worse it!
I had two tendenitis that got much better when I forgot them and focused on new injury! I say put a goal to start working out again after a long time. And this will help u relax and focus ,it looks like u r panicked! I know how u feel. Be smart and invest in resting ,stop all stretches and exercises for a time and start again.

[Sauce-head]

Yeah, I guess I should have outlined what kind of massaging to do earlier (although I thought I put it in the tendonitis article).

No no you did, I was just retarded and didn't do my homework on specific techniques. These changes have made a difference for sure. I feel like I can finally "dig" into the muscle, where as before I was solely using my finger tips and probably not getting into the belly of the muscle enough.

In general, cross friction tends to have the best results especially if you put the muscle into short non-contracted range of motion. It MUST be deep cross friction to break up stuff. You can't do piddly stuff and expect good results quickly.

Found that out the hard way! haha

A. For myofascial --

1. Squeeze your index and middle fingers against each other, and then pin your thumb against your index finger.

Put some lotion/massage cream on your thumb, and then exert deep pressure with your thumb along the muscle longitundinally.

Or you can have hot girls do it. Usually having someone else do it is better, but not if you can do it better yourself. There's very few people I've met who can actually do it better than myself (none that I wouldn't have to pay), so in general the best resource if you if you're educated. Unless the girl wants to learn.

This is very helpful.... I'm going to try this out...


B. Heat helps with blood flow, and loosening up muscles that are tight. Doesn't do anything specifically for scar tissue.

Soft tissue work is pretty much the only stuff that is going to break up the scar tissue unless you have such limited mobility that stretching will break up stuff. This is why massage is so important for high level athletes, and for those with significant injury conditions. Scar tissue jacks up everything.

Yeah no doubt. As I mentioned I feel a heavy-ness in my bicep that runs up my shoulder and into my traps on the left side.


C. That biceps stretch is fine if it works.

If you're having problems you should pronate your forearm and extend your shoulder as far as possible -- this will put the biceps in a pretty good stretch using any type of surface.

Another way you can do it is to exert pressure on the muscle, and lenghten and straighten it. This is another good way to break up stuff as well. Pressure helps put some tension into the muscle, and when you straighten it it will help break up stuff that inhibit the muscle from sliding properly + give you a decent stretch.

I like this method, whatever it takes to get that damn scar tissue out of my arm.

D. Ice helps with acute inflammation, yes. From massage possibly if you did a lot. If there's bursting blood vessels you may want to try it. Ice also makes the muscle contract/get tighter though so it may be a trade off.

Speaking of bursting blood vessels.... is that a sign of something? Lots of built up scar tissue? Lots of inflammation? Or just being too rough with the area?

Play around with it and see if it helps. Sometimes it does, sometimes it doesn't.


E. Yep. In general, most problems are due to:

1. improper biomechanics
2. poor posture
3. lack of mobility (including scar tissue)
4. muscle imbalances around the joints or referring joints

If you have crap posture, it will affect all of the other 3. Same with lack of mobility with your biceps as you are finding out.

Definitely

Basically, deep tissue massage everything from the neck to your wrist (need a partner for this one). Around the scapula, RC tendons, neck, rhomboids, triceps/biceps/etc. and you will feel much better. Obviously, it helps to have someone (girl preferably) who knows anatomy.... in both ways.

Thanks bro, I really appreciate all your help and support through this #hitty time!


I'm actually looking into going to a professional massage place. I want to try it out for a while and see what kind of progress I can make.

However there are soooo many sports massage places around my area. Is there anything in particular I should look for to help me figure out the best fit for me?

Oh and the clicking I hear in my shoulder..... will the massage help with that too? I've heard different things about clicking. Some say its not a big deal and can be ignored as long as you don't have pain. Others say its a serious warning sign of potential injury.....




SH

[Sauce-head]

Bro ,you are totally obsessed! Like me! I bit u keep on testing the painful movements to see if u got better ! every hour ! And this is aggravating it more! Guess what ,some of the treating options may help it or may worse it!
I had two tendenitis that got much better when I forgot them and focused on new injury! I say put a goal to start working out again after a long time. And this will help u relax and focus ,it looks like u r panicked! I know how u feel. Be smart and invest in resting ,stop all stretches and exercises for a time and start again.

I've had this issue for 5 months now and its completely changed my life.... no joke. I can't go to the gym, I can't release my stress and it sucks, I seriously can't wait to lift weights pain free again.

As far as being impatient, I would totally agree. Prior to these past couple months, I would rest for a week, then get back in the gym. I think the problem before is I didn't really realize what I was dealing with specifically. Now that I know I've got to get this scar tissue broken down, it makes it easier to understand why staying out of the gym until I'm 100% is necessary.

I haven't worked out since 12/29/09, coming up on two months. In my case if I sit there and do nothing, it won't help the situation and possibly make it worse. Scar tissue is a serious matter and definitely needs to be addressed. Regular tendonitis can definitely be healed by doing nothing.... wish that was the case for me...




SH

[Finnegan Bell]

I know how you feel bro. Did u go to an ortho? I went to 4 of them until I got correct diagnosis. I am off the gym for biceps tendonitis too btw.

[braindx]

Thanks bro, I really appreciate all your help and support through this #hitty time!


I'm actually looking into going to a professional massage place. I want to try it out for a while and see what kind of progress I can make.

However there are soooo many sports massage places around my area. Is there anything in particular I should look for to help me figure out the best fit for me?

Oh and the clicking I hear in my shoulder..... will the massage help with that too? I've heard different things about clicking. Some say its not a big deal and can be ignored as long as you don't have pain. Others say its a serious warning sign of potential injury.....




SH

"Speaking of bursting blood vessels.... is that a sign of something? Lots of built up scar tissue? Lots of inflammation? Or just being too rough with the area?"

Nah, some people just have that happen when you go deep.

Now if you were bursting blood vessels with superficial pressure then I may be concerned... Maybe some chronic inflammation or something.

---------

Massage places are variable. Basically, you want to find someone who can do exactly what you want and isn't afraid to use a lot of pressure.

Basically, you're going to want something like Graston/art/rofling except focusing on loosening everything (whereas more practitioners only do it on specific areas which is a mistake IMO).

I've seen much better results for shoulder issues if I dig into the forearms, elbow flexors, shoulders, and ALL of the muscles around the scapula. It's a whole chain of movement that is affected so you need to get work for everything.


--------

If there's clicking due to something like a strength imbalance or limited range o fmotion in internal/external etc it can be a prelude to something negative. Otherwise, it may not be.

Check your internal rotation with sleeper stretch -- see what angle you can make with the ground.

Do posterior capsule stretch.

Start doing some nerve glides (google first link), and wall slides (youtube this one).

This should help out your mobility significantly and let you feel better as well.

[Sauce-head]

I know how you feel bro. Did u go to an ortho? I went to 4 of them until I got correct diagnosis. I am off the gym for biceps tendonitis too btw.

Yeah it just sucks!!! I miss hitting the weights so bad!!! Seriously can't believe how much its affected me. Yeah I went to an ortho right away and got diagnosed with impingement. Feel like that was the somewhat right, but more so its bicep tendonitis that has turned chronic now.



SH

[Sauce-head]

"Speaking of bursting blood vessels.... is that a sign of something? Lots of built up scar tissue? Lots of inflammation? Or just being too rough with the area?"

Nah, some people just have that happen when you go deep.

Now if you were bursting blood vessels with superficial pressure then I may be concerned... Maybe some chronic inflammation or something.

---------

Massage places are variable. Basically, you want to find someone who can do exactly what you want and isn't afraid to use a lot of pressure.

Basically, you're going to want something like Graston/art/rofling except focusing on loosening everything (whereas more practitioners only do it on specific areas which is a mistake IMO).

I've seen much better results for shoulder issues if I dig into the forearms, elbow flexors, shoulders, and ALL of the muscles around the scapula. It's a whole chain of movement that is affected so you need to get work for everything.


--------

If there's clicking due to something like a strength imbalance or limited range o fmotion in internal/external etc it can be a prelude to something negative. Otherwise, it may not be.

Check your internal rotation with sleeper stretch -- see what angle you can make with the ground.

Do posterior capsule stretch.

Start doing some nerve glides (google first link), and wall slides (youtube this one).

This should help out your mobility significantly and let you feel better as well.

Thanks for your help braindx. I'm going to my homework on a massage therapist and report back in a few weeks, I'll probably PM you. I also agree about massaging the surrounding areas. In my case I think the restricted blow flow is what's causing the discomfort in my neck and slightly in my shoulder along with the bicep sting.

I ordered some Cissus as well, thought it was worth a shot as well.. Will post back on my results for both soon.



SH

[watertoy]

Try underarm cable flyes for chest. best mass builder.

you dont need to look like arnold but be in reasonable shape.





Id cancel doing bench press and try flyes.

[Sauce-head]

Try underarm cable flyes for chest. best mass builder.

you dont need to look like arnold but be in reasonable shape.





Id cancel doing bench press and try flyes.

I've been out of the gym for almost 2 months. I planning on starting light rehab soon if I get the okay... I'll keep these in mind.




SH

[braindx]

I wouldn't do any flys.... very easily aggravates the biceps tendon(s).