Biceps Tendinopathy Exercises

Biceps tendinopathy is an irritation or inflammation of the biceps tendon, most commonly occurring at the shoulder or where the tendon attaches to the elbow (distal biceps tendinopathy). Active rehabilitation through targeted exercises is essential for promoting healing, strengthening the tendon, and restoring pain-free movement. This home exercise guide is designed to guide you through a safe, progressive recovery program under the clinical direction of Dr. Christian Veillette.

General Guidelines & Safety Precautions

• Warm-Up: Warm up your arm before exercising. You can apply a warm compress for 5–10 minutes or perform gentle shoulder shrugs and arm circles to increase blood flow.
• The Pain Rule: Exercises should feel challenging but tolerable. Mild discomfort or a light stretch is normal, but you should never feel sharp, stabbing pain. If an exercise causes sharp pain, stop immediately.
• Progression: Start with light weights or resistance and slowly increase the load as your strength improves and your pain decreases.

Exercise 1: Active Elbow Range of Motion

Purpose: Restores natural mobility to the elbow joint, reduces stiffness, and prepares the tendon for strengthening exercises.

Equipment Needed: None.

Starting Position: Sit or stand upright with your arm relaxed at your side.

Step-by-Step Instructions:

• Slowly bend your elbow, bringing your hand toward your shoulder as far as comfortable. Hold for 1–2 seconds.
• Slowly straighten your elbow completely, letting your arm hang by your side. Hold for 1–2 seconds.
• Next, bend your elbow to 90 degrees with your palm facing down.
• Slowly rotate your palm to face upward, hold for 2 seconds, then slowly rotate it back to face downward.

Dosage: Perform 2 sets of 10 repetitions, twice daily.

Tips & Common Mistakes: Keep your movements smooth and controlled. Keep your shoulder relaxed and down, and avoid shrugging or using your body to force the movement.

Exercise 2: Isometric Biceps Holds

Purpose: Safely loads the biceps tendon without movement. Isometric exercises are highly effective for reducing tendon pain and building initial strength.

Equipment Needed: A very light dumbbell (1–3 lbs) or a table.

Starting Position: Sit at a table or desk. Place your elbow on the table, bent at a 90-degree angle, with your palm facing upward.

Step-by-Step Instructions:

• Hold a light dumbbell in your hand, maintaining your elbow at a 90-degree angle. (Alternatively, press upward against the underside of the table or use your other hand to press down on your palm to provide resistance).
• Hold this position steadily, keeping your elbow and wrist completely still.
• Maintain the hold for 10 to 15 seconds while breathing normally.
• Slowly release the tension and relax.

Dosage: Perform 3 sets of 5 repetitions (holding each for 10–15 seconds), once daily.

Tips & Common Mistakes: Do not hold your breath. Ensure the resistance is comfortable and does not provoke sharp pain in the front of your elbow or shoulder.

Exercise 3: Eccentric Biceps Curls

Purpose: Focuses on the lengthening (eccentric) phase of the biceps contraction, which stimulates cellular repair and tendon remodeling.

Equipment Needed: A light dumbbell (1–3 lbs) or a small water bottle.

Starting Position: Sit or stand comfortably, holding the dumbbell in your affected hand.

Step-by-Step Instructions:

• Use your unaffected hand to help lift the dumbbell up to your shoulder, bending your affected elbow.
• Release the support of your unaffected hand so only the affected arm is holding the weight.
• Slowly lower the weight, taking a full 4 to 5 seconds to completely straighten your elbow.
• Once your elbow is fully straight, use your other hand to assist the weight back to the starting position and repeat.

Dosage: Perform 3 sets of 10 repetitions, once daily.

Tips & Common Mistakes: The lowering phase is the most critical part. Avoid letting the arm drop quickly. Only use a weight that you can lower slowly and with complete control.

Exercise 4: Resisted Forearm Supination

Purpose: Strengthens the biceps in its role as the primary supinator (rotating the palm upward) of the forearm, supporting the distal tendon.

Equipment Needed: A light hammer or tool, or a dumbbell gripped at one end.

Starting Position: Sit with your forearm resting flat on a table, with your wrist and hand extending off the edge. Hold the bottom handle of a hammer or the end of a dumbbell, starting with your thumb pointing upward.

Step-by-Step Instructions:

• Slowly rotate your forearm so that your palm faces upward (supination), lifting the weighted end of the hammer/dumbbell.
• Hold the palm-up position for 2 seconds.
• Slowly rotate your forearm back to the starting position with your thumb pointing up.

Dosage: Perform 2 sets of 10 repetitions, once daily.

Tips & Common Mistakes: Keep your elbow tucked close to your side and flat on the table to isolate the forearm muscles. Do not let your elbow lift or your shoulder swing.

Always consult with your physical therapist or doctor before starting a new exercise routine. If any exercise causes persistent pain or swelling, discontinue it and contact your healthcare provider.

Disclaimer: This guide provides general exercise instructions and is not a substitute for professional medical advice. Always consult your doctor or qualified healthcare provider with any questions you may have regarding your specific medical condition and treatment plan.