20 Bicipital Tendon Technique

 

Click here to download a description of this technique.

The video is from my Deep Tissue Massage DVD, originally released on VHS tape in 1996.

Indications

If there is a problem with the tendon of the long head of the biceps, your client will have difficulty raising their arm across their chest or behind their back. They may also feel pain in the front of their shoulder.

Yergason Test: Have your client fully flex their elbow. Grasp their flexed elbow in one hand while holding their wrist in your other hand. Externally rotate their arm and pull their wrist down as they resist.  Shoulder pain indicates an unstable biceps tendon.

Cautions

This tendon repositioning can be painful, and it should not be performed more than 2 or 3 times during a single treatment.

Short fingernails are needed.

Technique

Have your client seated with their arm abducted to 90 degrees from their body and their forearm pointing up.

Grasp your client’s deltoid firmly with both hands, hooking your fingers around its anterior edge.

Have your client slowly rotate their arm internally, bringing their forearm parallel to the floor and eventually pointing toward the floor.

Your fingers will catch the tendon of the long head of the biceps, and then the bicipital groove will rotate toward the tendon so that the tendon can go back into the groove.

This technique only needs to be done once or twice.

 

Tendon of the Long Head of the Biceps

 

The tendon of the long head of the biceps brachii passes through a groove between the greater and lesser tubercles of the humerus and is held in place by the transverse humeral ligament. The tendon may slide out of the groove medially. This can cause pain and limitation of glenohumeral joint range of motion, especially in flexion and abduction.
The tendon enters the joint capsule to attach to the supraglenoid tubercle of the humerus. Adhesive capsulitis (frozen shoulder) may sometimes begin with an inflamed biceps tendon, which can pass the inflammation into the joint capsule.
The biceps brachii’s short head attaches to the scapula’s coracoid process, along with coracobrachialis and pectoralis minor. At the distal end, the biceps inserts onto the radial tuberosity and also to the ulna through the bicipital aponeurosis. The actions of the biceps brachii are shoulder flexion, elbow flexion, and supination of the forearm.

Recurrence of the issue

Clients with a slipped bicipital tendon may experience a recurrence of the condition, as the transverse humeral ligament may be sprained. I usually show a family member how to reset the tendon so the client doesn’t need to return to see me.
Releasing tension in the internal rotators of the humerus (pectoralis major, subscapularis) and strengthening of the scapula stabilizers (rhomboids, lower trapezius) may help prevent recurrence of the slipped bicipital tendon.
What causes a slipped bicipital tendon?
One prevalent shoulder injury that can occur while driving is a slipped bicipital tendon. Suppose you are wearing a seatbelt with the shoulder strap on, then reach behind the passenger seat to pick up something from the floor in the back. In that case, your arm will be externally rotated and extended, leaving your shoulder vulnerable. Lifting an item with your arm in this position can engage your biceps and cause the tendon to slip out of the groove. I encourage clients to avoid this habit.

 

Self-Care
Here is a self-care technique for repositioning the biceps tendon.

Member Comments

 

Dr. Mally,
I took your course in Virginia in May. You taught us a technique for the biceps tendon and I wanted to thank you. I had been experiencing pain in my shoulder for months and it has completely gone away. I had to show my husband the technique and he had to perform it on my shoulder one more time a few days after the class and I’ve been good since.
Sincerely,
Nadine Giampapa
Orange, Virginia

 

Robin Gayle commented on 12-Nov-2009 09:59 PM5 out of 5 stars

As a result of learning this wonderful technique from Dr. Mally, I was able to accurately assess this condition in 2 patients on the same day. By using the technique, I took them immediately out of their chronic pain conditions for which they had been treated by my employer, a chiropractor, for the last 9-10 months. Great news for the patients, not so good for me. My “services” were no longer needed at the end of that day. It was the shortest job I ever had as a massage therapist. Thanks, Dr Mally – for giving me the tools to get fired for the first and only time in my life. Both patients stayed in my private practice for many years following that incident.

Paryung Martin commented on 15-Mar-2010 05:04 PM5 out of 5 stars

Aloha Dr. Mally,

Deep Tissue Massage Sitting Techniques — 20 Bicipital Tendon Treatment

Some years ago I had taken a fall at work and injured my right shoulder. I went through almost three years of physical therapies, chiropractic, CT and MRI scans… but the pain persisted. The only remedy from my M.D. was pain killers and steroid injections (none of which I used). While my wife was serving her massage therapy apprenticeship, the school had a library with your Deep Tissue tape. While she was watching the tape I saw the Bicipital Tendon Technique and suggested she try it on my shoulder. There was a loud snapping sound – and the pain was NO MORE! It took a month or two of repeated use but eventually the tendon stayed in place for longer periods. Now there is no overt feeling when it slides out of place but I can feel when things aren’t right, she will reset and I’m good to go.

Thank you so very much – you have made my life much more bearable!!

Raymond Martin
Kapolei Hawaii

 

Marylisa Correia commented on 13-Dec-2010 07:46 PM5 out of 5 stars

The first time I saw this technique used was during a Swedish Massage course…Dr. Mally performed it on a fellow student and was able to reduce his shoulder pain. I had witnessed a different technique for this condition that was used on my son and it was VERY painful. I have not only used this method on my son and my husband (a Brazilian Jiu-Jitsu instructor), but I recently used it on a client who had been in constant pain for 10 months. We used the technique and although she experienced some tenderness….her range of motion returned almost immediately. As a Personal Trainer AND Massage Therapist, I am very grateful for such a valuable technique to HELP my clients and Family…Thank you!

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