How The Biceps Tendon Could Cause your Shoulder Pain!
Shoulder pain is something everyone has probably had sometime in their life. The problem is that many of us do not know where it came from, how to get rid of it, or what to do so it does not come back. If you subscribe to the GTS belief that “we should not sit more than 30 minutes a day, the 30 minutes should be on the floor, and whether standing or sitting we should change our position every 2 minutes,” then you might start to lose hope of ever being able to fix your problem.
However, at GTS, we have fixed countless shoulder problems. From shoulders with only a little pain, to people actually being misdiagnosed with surgery – we have seen it all. From impingement syndrome and rotator cuff strains or pain, to simple pathology issues, the long head of the biceps has been involved 100% of the time.
One might wonder how or why the biceps has anything to do with it, but the answer is actually quite simple (see pic below).
Notice how the long head of the biceps basically wraps around the shoulder head? It attaches very close to something known as the labrum. The labrum can also tear during powerful movements like a big tennis serve, throwing something, or doing something simple with a high level of momentum. With functional fitness and multi chain movements like the “clean & jerk” or the “snatch” in gyms like Cross Fit, it makes sense to see an increase in shoulder problems. We see shoulder pain more in the general population than in athletes, because injuries occur when the rotator cuff is weak and or the mobility, flexibility, and strength of the shoulder complex is out of balance.
Notice the supraspinatus at the top of the shoulder? This is the muscle that gets inflamed and starts to cause the pinching feeling in the shoulder – hence the name “impingement syndrome.” With the long head of the biceps so close to the attachment point, it is no surprise the supraspinatus starts to also have issues when the problems are left alone or not treated.
Now for the big “ah ha” moment. The therapists who deal with these injuries and the people that suffer from the pain (weekend warriors, cross fit athletes, college or pro athletes, and moms & dads) may notice that it is difficult to point to one exact spot where it hurts. Most people complain of the “radiating” pain or simply say it is the entire portion of the shoulder. Of course it is! At first it probably started from the supraspinatus or a weak external rotator muscle and then slowly started to creep into the biceps tendon through the fascia (connective tissue) that connects them. (We will discuss the importance of this in another blog, but Googling Anatomy Trains by Tom Meyer is a great place to start.)
The video below is of a good friend of mine who is also a very scary athlete. Don’t be fooled by his good manors and soft face. On the judo mat he is a trained killer and takes no mercy :-D However, because his sport requires so much tension while holding the judo “gi,” it is no wonder that his shoulder sometimes hurts. We will use this simple exercise to bring back the range of motion in his shoulder to help release the tension off of the overall shoulder structure. Many therapists would go straight to strengthening exercises, assuming that the rotator cuff or surrounding muscles are weak. But with his well-balanced training program and the “isometric” tension his shoulder is under when holding the gi, I would actually beg to differ.
So if you find yourself in physiotherapy and feel your shoulder pain is not getting better I highly suggest implementing this stretch into your daily routine! On a side note, measure your internal rotation before starting this and then again a few weeks after doing this stretch. I gained more on my right arm in the first few weeks of doing this stretch than I did in the previous 6 months of typical mobility work! No joke!
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