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    Dr. David Ryan - Bicep Tendon Injuries: What Are They & How Can They Be Managed?

    There are four basic types of bicep tendon injuries. Learn from the following details on what those injuries are, some of the best ways to identify, and how best to deal with them. Read on.

    http://www.bodybuilding.com/fun/drryan51.htm

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    Registered User King Creatine's Avatar
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    I'd like to know some more injury prevention stuff, rather than simply the "types" of injuries and perhaps one explanation for prevention.

    I had a distal bicep tendon tear seven months ago that required surgery, and was hoping this article would tell me the best way to do my deadlifts that wouldn't lead to a tear. Oh well.
    "There's no time to talk, only time to suffer."

    "Tolerance is the virtue of a man with no convictions."
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    Registered User Streinger's Avatar
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    I have recently recovered from quite a long-lasting (and painful) biceps injury. Even though I have a far better then average knowledge in the fields of anatomy and physiology (being a registered nurse and a paramedic), it took me long time to pin-point the origin of my injury and address it properly. I'll share it with you here, in hope that it might help someone to either recover from similar injury, or to avoid it altogether.
    How it started
    It started with a pain in my left arm, or to put it more accurately, in my left forearm, (what felt like) deep in my brachioradialis muscle. I tried all the usual remedies; icing it, massaging it, NSAR drugs...every time I would train my biceps, I would re-awaken the injury. Eventually, it got so bad that I was feeling pain when performing every day movements, like closing the boot of my car. It hindered my results on my last competition, as I just couldn't bring my arms more up and they were noticeably weaker then those of my opponents on stage.
    Why doctors couldn't help
    Don't get me wrong here; I work as a paramedic, meaning I'm within the health-care system, and I went to see several doctors in order to fix my injury. The conversation was surprisingly like the one in the old joke; a guy comes to the doctor and says "Doc, it hurts when I do THIS" and the doc replies: "Well then, stop doing it!"
    Seriously. They all (orthopedists, physiatrists..) suggested I stop with my training all together and allow time for the injury to heal. Never mind the atrophy of my muscles due to no training, and never mind the risk of new injury once I would start training again to build my arms back to where they were. The only good seeing all the doctors did me, was the ultrasound scan they made, showing there was no sign of muscle or tendon tear.
    How I figured it out
    The whole time, one thing was in the back of my mind, and once I started thinking about it more, it all fell into place. I couldn't do curls without pain, but the entire time, I was doing heavy back exercises with little or no pain at all. It made me think. IF my brachioradialis muscle was the cause of pain, if it was indeed the point of injury, then how come I was able to do heavy rows and pulls with no pain, when, in those movements, my hand was in neutral position (as opposed to supinated, when doing curls) meaning brachioradialis was involved MORE directly when I was rowing and pulling, then curling? Obviously, brachioradials muscle wasn't the injured one. It was, in fact, my bicep..or more accurately, the biceps distal tendon attachment on my radial bone, beneath brachioradials (and that fooled me into thinking brachioradials was the injured one) So now that I knew what was injured, I had to find the way how to work around the injury. I had to brush up on my anatomy, physiology and most importantly, kinesiology.
    The solution
    What did I really know about the bicep muscle? Well, it's tri-articulate muscle. Yes, most of us know it's a forearm flexor, and yes, some may even remember it's also a forearm supinator. But there's also a third function; it's also a shoulder flexor and it's involved in both arm abduction and arm adduction, meaning it's activated when arm is flexed in front of the body. And, the most important part; it can only do one at the time. Meaning; if it's activated as an arm flexor, it enters a so-called active insufficiency; it won't be able to fully engage in it's other function; elbow flexion and supination. Now, knowing this, I had to design my biceps workout routine around the exercises that engage biceps in arm flexion. That way, it would be less engaged (and thus, less strained) during elbow flexion, or to put it simply, during curling. So my exercises of choice became Lying Rope-attachment Curl On High Pulley and Two Arm Dumbbell Preacher Curl. Additionally, I was keeping my hands in between neutral grip and E-Z grip position, to reduce biceps involvement in supination. Only at full contraction, when biceps are in their strongest bio-mechanical position, I would perform supination, to briefly stimulate the short head, then return my hands to the previously described position and perform negative part of the movement.
    Conclusion
    Once I started to train like this, my recovery was surprisingly fast. At first, I felt a lot less pain during the training, and post-training, there was no pain at all...my arms felt tired, well trained, but no more injured. After only a few workouts, there was no more pain during workout at all, and soon, I was able to increase loads and my arms not only recovered, but started to grow.
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