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  1. #1
    Registered User Dirtylocks's Avatar
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    Never-ending proximal LHBT

    Anyone ever beat this without surgery?

    Been a year now and can't crack the code on getting rid of biceps tendonitis in shoulder.

    Done:

    -SMR (ball/roller)
    -dry needling
    -scapular mobilization
    -serratus anterior strengthening
    -RC strengthening
    -mobility work


    What else can I do before going under the knife?
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  2. #2
    Registered User brit-iron's Avatar
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    6 months off lifting. This and never doing certain exercises again were the only way I could get rid of acute tendon pain.
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  3. #3
    PT, DPT matthewkelling's Avatar
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    Unless you have this issue secondary to a torn labrum then what are you hoping that they will repair via surgery?

    Have you been to a medical practitioner with weight lifting experience?

    Tendonitis is almost always the result of poor mechanics or poor programming. Here are some items to consider:

    1. Consider getting a movement assessment to see what is wrong mechanically.
    2. Identify the movements that irritate the biceps and eliminate them from your regiment for at least one month.
    3. Use rest appropriately if you haven't yet.
    4. Use tempo weight lifting as a means of healing the tendon.
    5. Consider using 15g of gelatin combined with vitamin C and putting healthy stress on the tendon.
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  4. #4
    Registered User tkdnj's Avatar
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    Originally Posted by matthewkelling View Post
    Unless you have this issue secondary to a torn labrum then what are you hoping that they will repair via surgery?
    I'm hoping OP doesn't need surgery, but to answer your question matthewkelling, bicep tenodesis surgery detaches the injured bicep tendon from where it currently inserts in the shoulder and re-attaches it to the upper arm bone. I had both arms done during rotator cuff surgeries because the bicep tendon (on both arms) was damaged beyond what anything besides tenodesis could fix.
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    Registered User kyle38's Avatar
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    Originally Posted by tkdnj View Post
    I'm hoping OP doesn't need surgery, but to answer your question matthewkelling, bicep tenodesis surgery detaches the injured bicep tendon from where it currently inserts in the shoulder and re-attaches it to the upper arm bone. I had both arms done during rotator cuff surgeries because the bicep tendon (on both arms) was damaged beyond what anything besides tenodesis could fix.
    Ouch, feel the pain. Shoulders seem to be very common. I still have issues from time to time. I try to limit over head presses to 1 strength set and rest when needed. I had 3 screws put in and that took almost 5 years to recover from properly and another 5 to rebuild the shoulder completely. Even now I still get irritation from time to time. Woke up this morning with my shoulder feeling tired, but not clicking or or snapping. In cases like that, it's usually the long head of the bicep that is getting over worked and 3 to 4 days off should allow it to rest. I'll start back probably Saturday and just not do any overhead work. To answer the question, it's usually something you can work through but you have to watch it, change things up and rest when needed. And be patient, it can take years to recover to 80-90% depending on the injury
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    Registered User Dirtylocks's Avatar
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    Thanks everyone...

    I had 2 shoulder surgeries on currently affected joint (Left) for chronic dislocations (high school football/basketball) and actually had a tenodesis of the biceps done a year ago on the OTHER shoulder (Right).

    So I've had 3 shoulder surgeries in total.

    Since this tendinopathy of the L shoulder is only a year old I'd like to do nonsurgical approach for at least a couple years.

    I've been doing my best to mobilize the scapula, increase glenohumeral ROM, and avoid any directly OH resistance training.

    I'm hanging on every word posted in the replies so plz keep them coming!
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  7. #7
    Registered User PCRulesPSDrools's Avatar
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    Is there a connection between shoulder pain and bicep tendon? I have no pain with bicep workout per say but I've got shoulder clicking and pain in overhead press and a really unnatural feeling of something moving during bench press, though that doesn't hurt as much, when I flex my bicep (no load) I do feel a mild radiating pain down almost into my wrist. I actually first felt the shoulder pain reveal itself when switching to barbell squats ( squatters shoulder that never went away ), but I do a lot of overhead work ( actual job work ) too, so my shoulders take a beating all around, may have been wear and tear that was waiting to reveal itself, and first popped up on squats, but a part of me thinks the squats caused the damage.

    Obviously I'm in diagnostic mode here and trying to consider everything. I seen where the bicep tendon rides through that groove in the upper arm, and the un natural feeling in my bench press would correlate with what I seen demonstrated in a youtube video with that tendon popping in and out of the groove. There could be so much going on.
    Last edited by PCRulesPSDrools; 10-21-2020 at 04:33 PM.
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  8. #8
    Registered User tkdnj's Avatar
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    Originally Posted by PCRulesPSDrools View Post
    Is there a connection between shoulder pain and bicep tendon? I have no pain with bicep workout per say but I've got shoulder clicking and pain in overhead press and a really unnatural feeling of something moving during bench press, though that doesn't hurt as much, when I flex my bicep (no load) I do feel a mild radiating pain down almost into my wrist. I actually first felt the shoulder pain reveal itself when switching to barbell squats ( squatters shoulder that never went away ), but I do a lot of overhead work ( actual job work ) too, so my shoulders take a beating all around, may have been wear and tear that was waiting to reveal itself, and first popped up on squats, but a part of me thinks the squats caused the damage.

    Obviously I'm in diagnostic mode here and trying to consider everything. I seen where the bicep tendon rides through that groove in the upper arm, and the un natural feeling in my bench press would correlate with what I seen demonstrated in a youtube video with that tendon popping in and out of the groove. There could be so much going on.
    Absolutely. I’ve had rotator cuff surgery on both shoulders, and both times I needed a bicep tenodesis because the bicep tendon was almost totally torn. I never felt pain when I curled, but I felt the pain when I did a benchpress movement, and when I would hit an overhead double bi pose, and also when I threw a lat spread. Now keep in mind, I had tears all over my rotator cuff, but it’s very common for anyone who has rotator cuff tears also have proximal bicep tendon tears
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  9. #9
    Registered User kyle38's Avatar
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    Originally Posted by tkdnj View Post
    Absolutely. I’ve had rotator cuff surgery on both shoulders, and both times I needed a bicep tenodesis because the bicep tendon was almost totally torn. I never felt pain when I curled, but I felt the pain when I did a benchpress movement, and when I would hit an overhead double bi pose, and also when I threw a lat spread. Now keep in mind, I had tears all over my rotator cuff, but it’s very common for anyone who has rotator cuff tears also have proximal bicep tendon tears
    I stay away from heavy palm up curls for that reason. Hammer curls seem to be fine though, but I've has some really bad inflammation from the Bicep to the back of the shoulder. I also find, and correct me if I am wrong, but in most cases if your doing most the other benches and pulls, working the bigger muscle groups out works the Biceps get worked better than people think, so concentration curls in a lot circumstances can lead to over working that muscle group.

    Just a note, all my issues are on my injured side. I don't experience that on my left arm and shoulder.
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  10. #10
    Registered User tkdnj's Avatar
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    Originally Posted by kyle38 View Post
    correct me if I am wrong, but in most cases if your doing most the other benches and pulls, working the bigger muscle groups out works the Biceps get worked better than people think, so concentration curls in a lot circumstances can lead to over working that muscle group.
    You are correct in thinking that bench presses and shoulder presses work the triceps, and pulls work the biceps. This is called indirect work, and some folks do minimal (or no) direct tricep/bicep work if they feel the indirect work from the compound movements is adequate for hypertrophy. However most lifters (especially bodybuilders) will add some direct bicep/tricep work. As far as overall volume goes for biceps and triceps, you should consider how much compound movement work you are doing. If your biceps/triceps are constantly sore or are not growing/getting stronger, it could be that the total volume (direct plus indirect) is too much. In that case, I would reduce the direct work a bit and see what happens.
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  11. #11
    Registered User kyle38's Avatar
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    Originally Posted by tkdnj View Post
    You are correct in thinking that bench presses and shoulder presses work the triceps, and pulls work the biceps. This is called indirect work, and some folks do minimal (or no) direct tricep/bicep work if they feel the indirect work from the compound movements is adequate for hypertrophy. However most lifters (especially bodybuilders) will add some direct bicep/tricep work. As far as overall volume goes for biceps and triceps, you should consider how much compound movement work you are doing. If your biceps/triceps are constantly sore or are not growing/getting stronger, it could be that the total volume (direct plus indirect) is too much. In that case, I would reduce the direct work a bit and see what happens.
    That's how I have understood it. My arms are right under 19 inches, most of that is tricep. I can push the bicep a bit more, but on the right side I get inflammation if I push too hard, again that is the injured shoulder. I've been fortunate to be able to put on a lot of muscle mass naturally, even with the injury. That's due to high T levels, my dad was a body builder and he still outsized me at 6 2, but I did get stronger overall, but I put on more fat as well. my mom's side, German, stood at 5 8. If I could stick to a diet I could cut easy 220lbs and be cut, naturally at 5 11. That's just to say, even if you have to compensate due to injury, you can make it work. I still haven't had the disipline to diet like that.

    I should mention, and just because it came so naturally, I didn't start working out really until I was 31. I was 180lbs and smoke 2 packs a day and drank a lot. It wasn't until I got put on blood pressure meds, at 31, I changed. My blood sugar got all wonky too.

    When it comes easy, at least for a lot of us, procrastination seems to get justified. It shouldn't, there is always a price to be paid.
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  12. #12
    Registered User tkdnj's Avatar
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    Originally Posted by kyle38 View Post
    That's how I have understood it. My arms are right under 19 inches, most of that is tricep. I can push the bicep a bit more, but on the right side I get inflammation if I push too hard, again that is the injured shoulder. I've been fortunate to be able to put on a lot of muscle mass naturally, even with the injury. That's due to high T levels, my dad was a body builder and he still outsized me at 6 2, but I did get stronger overall, but I put on more fat as well. my mom's side, German, stood at 5 8. If I could stick to a diet I could cut easy 220lbs and be cut, naturally at 5 11. That's just to say, even if you have to compensate due to injury, you can make it work. I still haven't had the disipline to diet like that.

    I should mention, and just because it came so naturally, I didn't start working out really until I was 31. I was 180lbs and smoke 2 packs a day and drank a lot. It wasn't until I got put on blood pressure meds, at 31, I changed. My blood sugar got all wonky too.

    When it comes easy, at least for a lot of us, procrastination seems to get justified. It shouldn't, there is always a price to be paid.
    And I'm the exact opposite. 55, here, been training since I was 16, I have a ton of discipline, grew up with great bodybuilders (so I had good knowledge), and have a degree in Nutrition, but I am not genetically gifted for bodybuilding. Still love it!
    Last edited by tkdnj; 10-25-2020 at 08:37 AM.
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