Biceps Strain

Mark: Hi, it's Mark from Top Local. I'm here with Wil Seto of Insync Physio in Vancouver. One of the best physiotherapists in Vancouver, many times as voted by his customers as one of the top physios. And we're going to talk about bicep strength today. How are you doing Wil? 

Wil: Hey, Mark thanks, I'm doing really well. I appreciate the shout out. So yeah, we'll talk about bicep strains today. There's a couple of different areas that you can actually strain it.

So this one particular person, he was a really avid rock climber and he was in his late twenties  when you know, had the injury. And it was actually a rock climbing injury where he ended up hyperextending his arm. And, he basically straightened his long head on his biceps.

And that's typically the, like for the biceps, the one that you tend to actually strain because you actually have two, that's why it's called biceps. You have the long head and the short head. And he strained it, at the actual point where it attaches to the shoulder, which is called the origin point.

And, you can also get issues happening, kind of more towards the elbow, which is called the insertion point of the long head of the biceps and your short head also attaches on there too. But with this one in particular, it was a traumatic injury. And, it looked like it was also a few other things going on too.

So when you have this kind of an injury where, especially with this mechanism, with this particular person, you know, he ended up hyperextending because he broke off the hold with his right arm and he held on with his left and it ended up hyper extending that left.

He had this pain that was ongoing. For probably a good two or three months until he actually had some proper physio. And so basically when we went through the process of looking at what was happening, one of the things that you have to consider, especially pain in the shoulder, you have to actually look at the shoulder and assess that and see what was going on because the long head of the biceps actually attaches close to the rotator cuff and sort of like, helps and assists with rotator cuff function. And so we had to clear all that stuff first and then really start to differentiate and look at okay, yeah so is it just the biceps tendon and is it just that area?

And the other thing was also looking at other components because with the long head biceps injury, with this type of mechanism, you can also injure the capsule because that's where the biceps long head attaches and also the cartilage. 

So there's a specific term that we use in the physio world called the SLAP lesion. So SLAP is just an acronym for a superior labral anterior posterior injury. And so that involves like the long head of the biceps. And so the speer capsule, interior aspect of that whole area, and the labral is basically the cartilage.

And so, this person came in, like two, three months after the injury and was only able to move their arm about around this high. And they were actually getting some physio somewhere else and it just wasn't really helping. I think what I was assessing too was also the whole shoulder. The whole shoulder and everything, what was going on and I realized that, you know, we had to actually address all the stuff that was going on. And so, the long head of the biceps was definitely the main thing in question. And as we sort of started treating him and it started progressing, a little bit by little bit, and it was getting better actually within the first two weeks. I had made a suggestion and I said, because of the mechanism of injury and what I thought was going on, which was this SLAP lesion, that we get an MRI. \

And interestingly enough, they were able to get an MRI set for like three months pretty quickly after they saw me. But then, we actually got full range back within like a month. And so a month of working on this issue of not being able to fully flex and come out this way and he had full flection and also behind the back motion. So there's range of motion was like 100% after four weeks. We also worked on the strength and surprisingly six weeks later got him back rock climbing.

Mark: So there you go. If you need some help with your shoulders, your biceps you've injured yourself. It could be rock climbing. It could be throwing baseballs. It could be many of the things we use our shoulders for many different actions, the guys to see our Insync Physio. You can reach them in Vancouver at (604) 566-9716. Or in North Burnaby, (604) 298-4878. Check out the website insyncphysio.com. You can book online there. You can pick the physio you want to see. Wil's in real demand so it might take a while to see him, but he is one of the very best in Vancouver. And thanks a lot Wil.

Wil:  Thanks Mark. And oh, one more thing to add I almost forgot that he did get that MRI scan done, and it did show a long head biceps tear along with a superior interior capsule tear and some cartilage damage. 

Mark: But he's all good now and back climbing. 

Wil: All good. Now and back climbing. 100%.