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Biceps Brachii |
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Arm Flexor |
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This muscle weakly assists flexion of the arm at the shoulder, assists abduction (moving away from the body) of the shoulder when the arm is laterally rotated, flexes the arm at the elbow when forearm is supinated (palm up), strongly supinates the forearm from a pronated position when the arm is partly flexed, helps seat the head of the humerus in the glenoid fossa when a heavy weight is being carried in the hand, and assists in horizontal adduction (moving towards the center) of the arm across the chest. |
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Pain is referred upwards over the muscle and into the anterior deltoid region of the shoulder. Central TrPs in the biceps may also initiate a downward pattern of milder pain to the antecubital space (in front of the elbow). Other phenomena that are referred to some part of the volar (palm side) forearm and hand include deep tenderness, erythema, paresthesia, pallor, and a feeling of weakness. |
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People who have TrPs in this muscle complain of superficial (and not deep) pain in the anterior shoulder. Pain occurs during elevation of the arm above the shoulder level during flexion and abduction. A person may experience a sudden “catch” in the shoulder when abducting the arm.
Tenderness over the bicipital tendon, diffuse aching over the anterior surface of the arm, weakness and pain on raising the hand above the head, snapping or grating sounds from the taut long-head tendon on abduction of the arm, and an associated ache and soreness in the upper trapezius region also can be experienced by those with active TrPs in the biceps muscle. It is still possible to be able to lie comfortably on the affected side without pain. |
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- Bicipital tendonitis.
- Subdeltoid bursitis.
- C5 radiculopathy.
- Bicipital bursitis.
- Glenohumeral arthritis.
- Painful biceps tendon instability.

- Overstress during activities like a strong backhand tennis stroke executed with the elbow straight and the forearm supinated
- Lifting heavy objects with the forearm supinated (palm of the hand upward).
- Sudden lifting with the arm extended (raising the hood of a car or lifting boxes at arm’s length).
- Episodic elbow-flexion load (using an electric hedge clipper).
- Unaccustomed vigorous or repeated supination (turning a stiff doorknob or using a screwdriver).
- Overexertion (as in shoveling snow).
- Playing the violin.
- Hard serving in competitive tennis.
- Sudden overstretching of the muscle (as in catching a fall with the arm by reaching behind to a railing with the elbow extended).
- Key TrPs in the infraspinatus muscle.

- Learn to lift and carry objects with the forearms pronated in order to transfer some of the load from the biceps to other muscles.
- Avoid sleeping with the elbow tightly flexed by placing a small pillow in the crook of the elbow to prevent prolonged shortening of the biceps.
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References :
Simons DG, Travell JG, Simons LS, Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1, 2nd Ed. Baltimore: Williams and Wilkins, 1999.
Travell JG, Simons DG, Myofascial Pain and Dysfunction, vol 2. Baltimore: Williams & Wilkins, 1992.
This information is not intended to diagnose, treat, or cure any disease.
A proper diagnosis should be sought from a licensed health care provider. |
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