- Hi, I'm Bob Schrupp, physical therapist.
- Oh, Brad Heineck, physical therapist
- And together we are the most famous physical therapists
on the internet.
- In our opinion, of course Bob.
- We've got a lot of requests Brad for,
they want, a video on bicep tendonitis.
People are feeling pain in they're bicep tendon.
And that's usually when you're going to feel it
is when you're doing curls.
- Sure.
- Or what we call resisted flexion.
So if you take your hand, let's say it's my right arm.
- Right.
- And I offer resistance here and I push
and I don't let my arm go up,
that's where you might feel it.
More often it is going to be doing like a curl.
- Sure
- You might also feel it going like this
cause' it does serve a little bit of that function too.
- Exactly.
- So we're going to show you where the bicep tendon is
and also how to go ahead and do the top treatment for it
which is usually a type of massage we do,
cross fiber friction massage.
- Sure.
So, alright the first thing Brad I was going to show,
let's show the group
- You were but now you're not going to?
- I was, and now I'm going to
- Oh whoa, okay, we are going too, good.
I like this. I like the packer ball here.
- Yeah. I like it too, because it's like an alien coming
out of the body.
- Yeah. You're just jealous Bob.
All right. Let's get to the subject.
- Are we about right there Nancy? Okay.
So, the tendon and this again, bicep means two.
So you got two tendons that are going to test
but the one we're only concerned about is the long head.
Brad, do you want to show them?
- Sure. You can see this groove
in the top part of the humerus here.
Yep. Right there that tendon,
that's what that groove is for.
The tendon slides right through there
and it connects, where does it connect Bob?
- Right up here in the supraglenoid fossa.
- Yep. Right there, wraps all the way around there
and that's the tendon down in this area.
That's where you get that muscle belly where
the guys always like to get that pumped up.
- Now, if you actually tear that tendon
what you're going to see Brad, and now you've seen it
I'm sure on people right?
- Yeah.
- Where the bicep actually gathers as a ball
and it's way at the end here
and there's nothing you can do about that.
They usually don't even surgically repair those.
- Oh really?
- Yeah. Usually they just let, them go.
You still got bicep function,
not as strong obviously,
but they just don't do anything about it.
As far as this groove is concerned.
Don't get too hung up on that.
What you're going to try to do is find the painful spot
and go ahead and we're going to start some rubbing.
So let's go ahead.
- So are you saying that over that groove
is where you're going to do that massage?
- Over the groove or a little bit distal to it,
or a little further down the arm.
- Right. Right.
- Find the tender spot.
- Okay.
- Now the position you want to be in,
and you can do it through the shirt
or you can do it, it'd be better probably to,
do it on the skin.
- Yeah.
- But you're going to take your arm,
you're going to go ahead and relax back,
you're going to put it on a pillow,
you're going to turn your palm up
and out a little bit like this,
and now you're going to go ahead
and try to find the spot.
And you're going to put your fingers,
Hi Nancy, you put your fingers like this
maybe one over another or three together or two together.
Something where you can apply a lot of pressure.
Does that make sense Brad?
- Yeah. I thought you were giving them the
- Yeah. Brad's joking we got humor here.
- No, we love you guys. We won't give you the (laughs)
- Yeah
- Okay. So, palm up, you're going to go ahead
and find the tender spot.
- Right?
- Okay. I found the groove right there.
I know where the groove is.
So, I found the groove
and you're going to rub across the tendon.
Now you're not just moving skin here Brad, are you?
- Right.
- You can, even if you don't get all the way up here Brad,
you can show them.
- My massive deltoids don't allow me to focus here
- Yeah, yeah
- Massive deltoids (indistinct)
- Okay. You're not just moving skin,
you're getting deep down in there and rubbing the tendon.
Cause' what happens after,
when that tendon has become irritated
and there's scar tissue that's laid down,
we're trying to get that scar tissue to break up.
This also brings more blood flow to the area
Sure. - - So it helps it heal,
- Right?
- but you want it to heal strong
cause' normally what happens is that,
and this is why this becomes a nagging injury is that,
it gets tore.
It gets some scar tissue laid down.
And the next time you use it
that scar tissue breaks open again.
- Sure.
- And the healing process starts all over again, right?
- So what you wanted to do is have it heal real strong.
So that next time you use it, you try to use it,
it doesn't break open, it stays strong and you're good.
- And so let's make this clear.
Say, one weekend I had a big project in my garage
is going to hang sheet rock,
and I normally don't do that,
so I'm really lifting hard
and I irritate that tendon, it's really sore.
- I don't know that that would be,
it would probably be maybe a couple weekends.
It tends to be more of a progressive thing
an overuse injury.
- Well whatever you get it. So it's real sore.
- Right?
- Are you going to get after it right when it's real tender
or what kind of length of time?
- I would start by icing.
This is the sign that you want to look for Brad.
You go ahead and start some rubbing on it, find the area.
You're going to rub one finger over the other
two fingers together.
You're going to rub real hard.
If after a minute the pain is getting worse,
it's not getting better,
it's not starting to numb out,
then it's too sore, it's too acute,
you need to just put some ice on it.
- And wait a day?
- I would wait a day and try it again in a day.
Sure. - - Yeah.
Then, you know, if you get the great sign,
which is what we would like to see,
is that you're rubbing it
and then after a minute it actually starts to feel numb
or it's actually even feeling better.
Right? - - Beautiful.
- Now you can go up to five minutes.
I don't know if you can tolerate that long.
It's hot in here today Brad.
- I know it's hot.
- If you can go up to five minutes,
you can even go longer Brad.
They talk about doing it for 20 minutes,
Right, in (indistinct)- - Yeah in (indistinct)
So, don't feel like you're going to overdo it.
Just don't break the skin down,
I've seen that done where you
actually get a sore on the skin.
- Right? Yeah. Especially if you got big nails.
- So again, pillow, palm up find the groove,
or find the sore spot rub, you know,
maybe you have to go up and down a little bit
till you find the spot, rubbing really hard,
going to do a good five minutes,
You're going across - - going across the fibers,
yeah, breaking it up, getting some blood flow to it.
If after a minute it's getting worse.
You're backing off. You're putting ice on it.
If after a minute it's getting better or numb, beautiful,
keep going for five minutes.
You can do this every day for, you know, a couple weeks.
And this generally responds very very well
to this treatment.
This is one of these treatments that, I've had this
and it was a nagging injury kept going on, kept going on.
I did this. It was, I did a couple treatments, Brad,
and it was fine.
- Yeah. I gotta tell you just from personal, just recently,
I got tendonitis in my Achilles tendon
and I've been doing it
and I'm getting in there, - - Yeah
and I think we had a video on that too.
- Yeah.
- But it's just like you said,
after about a minute or two it started feeling good
and I kept working it, working it, it kind of hurt so good.
My figures got so sore
but it certainly improved my symptoms.
- Yeah, it'll do the job.
That's one of our popular videos you have to look for, so.
Alright, Brad, we're not just pretty,
- We're pretty ugly. I mean, we're pretty old.
- We're pretty old.
So, if you're old too, like us
you could always subscribe to us
cause' we're going to provide you videos
on how would stay healthy and fit
well into your forties, fifties and over.
- We've got people in their nineties.
- Yeah? Do we really?
- Yeah, yeah, be careful with that.
- To the Moon Alice.
- Bye Bob.
(bouncy piano music)