That’s why I don’t recommend that friction massage. It’s like rubbing a rubber band against a rock Hi everyone. Mr. Physio here. Today I am going to talk about biceps tendinopathy and as always, you will get a lot of information and techniques from this video. So please watch till the end and none of this video should be missed out Let’s have a look at the muscle’s location first Biceps starts from the inside of the forearm bone and divides into short and long heads to attach to the tip of the shoulder blade. If you look at the upper arm bone, there’s a little groove where the biceps tendon, long head tendon, sits in When you google up biceps tendinopathy, you will see a long head of the biceps problem only Have you thought of why? I will tell you later Before that, we should know their function properly, but we all know biceps gets shortened when it bends elbow and get stretched with arm straight. So that’s when you think the starting point is shoulder, but if you think the starting points is forearm, and biceps contracts, that pulls your shoulder forward. so people with round shoulder can have this muscle tight and shortened and they easily get tight because we do a lot of things with our arms and we always actually have our arms bent so we actually put them in a shortened position. If you put a muscle in a shortened position for a long time that will get tight and short so what happens if it’s too tight? I’ve got a spiky ball that’s head of my humerus. And this is my long head of the biceps tendon. I told you there’s a little Groove in that upper arm bone and the long head of the biceps tendon sits like that in the groove. If the biceps muscle’s too tight that pulls the tendon down and it can get rubbed against the bone. so It’s being stretched out and Compressed at the same time against the bone and I keep telling you in almost all my videos tendons don’t like compression and stretching at the same time. You’ll get sick of me telling you this again and again, if you’re my old subscribers but, this is very important the problem starts from the friction so this answers the question, right? it’s more common to have long tendon problem because it’s it’s in that groove. It’s near the Bony area and rubbed against the bone. That’s why I don’t recommend that friction massage. Some people say cross friction massage creates a bit of trauma, microtrauma to the tendon so that the tendon can repair themselves. Wait a minute… are you serious..? Your tendon gets painful at the moment because it doesn’t have the ability to recover from the damage caused by this friction Why would you keep rubbing the tendon, which doesn’t have the ability to recover even from that current damage? … most importantly there’s no evidence on cross friction massage. And this is the best research I can find on the effect of cross friction massage Anecdotal… that’s not really objective… So what we need to do is actually, first of all, relax the muscles if your muscle is a little bit relaxed, that will actually reduce the tension on the tendon here To massage that muscle, we are going to use a ball. Just simply place the ball in the middle of the muscle. So maybe 5 centimeter away from the elbow 10-centimeter away from the top of the shoulder Go side to side like that across the muscle belly for about 30 seconds, and then you press down into the muscle and just activate/relax, activate/relax do that about 30 seconds as well and do more on tighter spots Next will be eccentric exercises, the lengthening exercises, where muscle gets lengthened under loading Pull your shoulder back and try to bend your elbow towards you and just push it away with your left hand. My muscle is trying to contract but it’s being lengthened because I’m pushing it away. (again) pull it towards you~ Push it away (right hand lets left hand win) If that’s difficult, you’d probably want to use a weight. Start from here and lower down slowly and then pull it up with the other hand. Don’t just do this shortening contraction
(don’t pull up with right hand) we want that lengthening part of the exercises only as you control that weight using that muscle, the muscle is being lengthened that’s eccentric contraction(lengthening exercises) and another eccentric exercise for bicep tendon is rotation biceps muscle get shortened and that pulls the forearm out to the side so We want to do the opposite action so that your muscle can get lengthened under loading Hold one end of the weight like this and just slowly… lower down… Pull it up using the other hand and lower it down slowly in 5 seconds…. Coming up and that’s also effective for tendon rehab. And the last exercise you want to do is rotator cuff exercises rotator cuff muscles and biceps muscles work together they are actually attached around that head of the humerus so they stabilize the head of the humerus on the shoulder joint. So Humerus doesn’t get pulled up when the deltoid muscle lifting your arm up. Deltoid muscles are attached in the middle of the arm so when they contracts that pulls the upper arm bone up the long head of the biceps together with rotator cuff muscles attached like this, They pull the head of the humerus down like that. So if the rotator cuff muscles are too weak, the Humeral head goes up and that will put more stretch on that bicep tendon, which is not ideal. So please see my rotator cuff series today we talked about the biceps tendon problem and like other tendon problems the biceps problem also starts from that tendon being stretched out and compressed against the bone. so stop massaging your tendon Instead Massage your muscle and lengthen up muscle tissue with that eccentric exercises. I’ll see you next time. Rehab safely!