Baseball pitchers Duffy, Hernandez, Kershaw and Pomeranz are just a few among the professional baseball players who have sustained bicipital tendinitis during a major season. Bicipital tendinitis usually occurs from overuse or repetitive trauma to the shoulder, which are common in overhead athletes such as baseball pitchers, who place such high demand on their arms. Repetitive motions like throwing at high speeds can cause tendinitis.
- Kansas City Royals’ pitcher Danny Duffywas placed on the 15-day disabled list with left biceps tendinitis in 2015.
- In 2017, Seattle Mariners’ starting pitcher Felix Hernandez reportedly placed on the10-day disabled list with right biceps tendinitis.
- The Los Angeles Dodgers'ace pitcher Clayton Kershawwas placed on the 10-day disabled list with left biceps tendinitis in 2018.
- The Red Sox placed left-handed pitcher Drew Pomeranzon the 10-day disabled list with tendinitis in his left biceps, 2018.
What is bicipital tendinitis and how do I get it?
Bicipital tendinitis is an irritation of the biceps tendon in front of the shoulder and is a common cause of shoulder pain in baseball. In throwing or pitching, it usually happens when the shoulder is moving coming from a maximally stretched out position to a forceful forward motion for a throw, transferring an extreme amount of force to the biceps. This is more known to baseball athletes as the late cocking and deceleration phases. If the body is unable to dissipate this force, all of the structures about the shoulder, including the biceps, takes it all, and thereby injured.
NOTES ON IMPINGEMENT SYNDROME:
Similar to bicipital tendinitis, impingement syndrome is also frequently common in throwing athletes. Impingement syndrome is an injury where the rotator cuff tendons get trapped and “impinge” between the arm bone and the bony prominence of the shoulder blade (acromion). Swelling occurs, and throwing positions, such as in pitching, can be very painful and disabling.
What are the signs and symptoms of tendinitis?
- The classic symptom is a deep and throbbing pain in front of the shoulder.
- Repetitive overhead arm motion, elevated pushing or pulling, or lifting exacerbates the pain, and the pain may get worse at night.
- Bending the elbow against resistance also aggravates the pain.
- Instability of the tendon may present as a palpable or a "click" heard during shoulder motions.
RUPTURED BICEPS TENDON:
- A sudden "pop" sound, followed by pain, swelling, and bruising in the shoulder with a visible bulge above the elbow, indicating severe rupture.
- If previous biceps tendonitis is present, the pain resolves right after the tendon rupture.
- "Popeye" arm or the bulging muscle in the middle of the upper arm that is due to the biceps muscle contracting together into a tight space.
How is tendinitis treated?
- Resting for a few days, reducing painful activities while taking pain medications may be enough to resolve the biceps tendonitis.
- Ice application helps in swelling and inflammation.
- Physical therapy to strengthen the muscles in the shoulder region to develop a step-by-step plan to gradually return to sports activities.
- Persistence of symptoms may benefit from steroid injections or surgery.
RETURNING TO BASEBALL
It’s generally safe to return to throwing and pitching once the pain has subsided and the muscles have regained their strength. It’s best to slowly return to sports following an appropriate conditioning program consisting of progressive throwing program.
MANAGING BICIPITAL TENDINOSIS WITH RECOVAPRO
Localized vibration through Recovapro massage guns facilitates enhanced circulation, which the long head of biceps is deprived with. Increased blood facilitates healing and fast recovery from injury.
- Greater muscle tension reduction and muscle fiber spreading is accomplished by applying the sweeping cross fiber technique with the elbow extended so the muscle is in a lengthened position. Move the tool from side to side along the whole length of the biceps.
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Deep longitudinal strippingincreases pliability and reduces tension in the muscle. A broad application of pressure with the round or flat head can be used initially for more general work, while a small contact surface with the bullet head provides better stripping effect. The power head can also be utilized. With elbow extended, hover over the biceps brachii working from the elbow going up to the proximal tendon.
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Deep frictionis used to encourage fibroblast proliferation and collagen synthesis to heal the damaged tendon. The power head or bullet head moves from side to side.
NOTES:
- The tendon is likely to be tender, so adjust speed and pressure levels to comfort tolerance.
- If discomfort with transverse friction is felt over the tendon, perform deep friction techniques longitudinally instead of transversely.
- Caution on pressing the median nerve running along the muscle against the underlying bone. The muscle belly is not that large on the majority of people so a great deal of pressure is not necessary.
Recovapro massage guns can deliver the massage techniques required for shoulder injury rehabilitation through its 5-speed and power settings and interchangeable head attachments. Combining different speed and pressure contacts via the attachments allows varied techniques that can address every grade of shoulder injury, including just indulging after a strenuous workout.
