Chronic Bicep Problems

Michael Schaub

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Hey Dr. 8a, first of all thanks a lot for the time you put into responding to the questions in this forum. I have the following problem: Since several years I develop pain in the lower part (close to the elbow) of my left biceps. Before this started I already had some problems with the left shoulder. This shoulder might be a bit bad off, anyways, as I have had my upper arm broken 8 years ago right at the head of the humerus bone very close to my shoulder. They had to perform quite invasive surgery and maybe further injured some connective-, tendon-, or muscle-tissue. Ever since my shoulder was likely to hurt, but I was able to keep that under control by doing shoulder stabalizing exercises (with rubber bands and weights). But at some point during the last 3 years I more and more frequently developed pain in the biceps of this arm. I first thought that it has to do with my shoulder, but now I can clearly tell the difference as the condition worsened during the last year. It is a constant, sometimes stinging and numbing pain, located in about the lower fourth of the biceps muscle towards the elbow. When it gets bad following too much climbing, my whole arm feels weak and somehwat numb. A doctor told me before that it´s probably the lower biceps tendon and it just needs some rest, but he did not look at it in detail. Also I seriously tried to rest as I have spent 3 months without climbing last year. Yet the pain came back instantly when I started climbing again, and the problem was as before. When climbing, the most typical painful move is on a steep climb to twist in and lock off low with that arm in order to reach up high with my right arm. The pain is even worse, if I do this move backwards (downclimbing motion). I used to put tape around my arm just a bit higher than my elbow, and it helped me somewhat (you can actually see that in my profile picture, haha). However, during the last half year, the conditon worsened and, even with tape and no initial pain, I only have about 50-100 meters outdoor climbing on just vertical routes, before the pain starts to be bothering/worrying. Maybe the condition might arise from the shoulder stabelizing exercises I do  (internal and external rotation, lateral rise, propped external rotation, push ups, rowing exercises). Also I´ve been told before by an athletic trainer that my shoulders and joints are quite loose, and that I should avoid stretching and rather focus on building stabalizing muscles. So of the upper body I only stretch my forearms, pec muscles and the painful bicep, but nothing around the shoulders. Regarding the stretching of that biceps, I haven´t really found any exercise that feels like its an effective stretch. Maybe you have some advice for me (or anybody else here). It´d be highly appreciated! -Michael

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Gianluca Boldetti

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I had something similar last year even if not as bad...only lasted a couple of months. I managed to control it with few simple ideas : -ice massage, daily. You simply make a big piece of ice, take it with a towel, and gently rub it in cicles around the part, applying some pressure -occasional anti-inflammatory gel. -careful warmup -wearing a warm socket (w/ end part cut) over the elbow, for climbing I mean This last one is odd : no one reccomended it, never read about something like that...but I saw this pictute of fred nicole wearing something like that and decided to try it. It seemed to be very effective!

Bjoern Alber

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Hi Michael As I read it from the information given you most likely suffer from a cronic inflammation of the biceps tendon at it insertion on the forearm. However the flexing of the elbow is performed by 3 different muscles : the biceps brachi (biceps) , the Brachialis ( a small muscle running from the upper arm bone (humerus) to the lower arm bone that forms the elbow (Ulna), and the Brachioradialis (running from the upper arm bone to the lower arm bone that connects to the tumb (Radius). The last two muscles are working mainly when working statically (like a lock off) with bent arms and depending on which muscle is inflamed you will feel pain mainly on the outside (Brachioradialis) or the inside of the arm (Brachialis). Considering your earlier shoulder problems (which you seem to take good care of - so continue what that regim) I would not stretch the shoulder but certainly increase the biceps stretching. Try standing, with a slight forward bend, hook the back of the hand inside a doorpost at shoulder level - press the hand against the doorpost for 10 sec. then relax and twist your body away from the doorpost - keep this stretch for up to 60 sec. Repeat at least 4 times per day and allways before and after a climb workout. Get a prescription for a anti-inflammatory drug (ex. Voltaren) and take it regularly for at least 3 weeks. The strategies Gianluca outlined above works well as a supplement to this. The trick with the stocking (preferable wool or thin neoprene) is well used by competion Kayakers to keep elbows and wrist warm under extreme stress in cold climates - use it to keep the injured elbow extra warm. Remember - most important - I can only make an educated guess - you should get a sports medicine trained MD to examine and diagnose your injury - this will avoid loosing a lot of time trying remedies for something you actually don't have Best of luck Björn

Ian Walters

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This is the first mention i've heard of another climber experiencing what I do. Normally after ~2 weeks of bouldering, regardless of the difficulty, i start to experience said pain, presumably the brachialis, as my pain is on the inside quarter of the left bicep. If i continue to boulder, the pain worsens to the point where I cannot boulder anywhere near my limit, or for more than half an hour. I recently tried routes almost exclusively in the gym for an extended period of time, and experienced no problems, which was heartening. The only way i have ever been able to make the pain go away for extended periods of time was by resting for an extended period of time.(i.e. two weeks or more) though these other possible helpfuls provided by dr. 8a sound interesting, and I will try them, as I have been frustrated by this for a long time. thanks 8a

Michael Schaub

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Thank you guys for the advice!! I´ll start doing what you´ve suggested and see how that works for me. Having a climbing-knowledgable MD would be great, but I have yet to come around one here in Barcelona (advice also welcome). At least I won´t need a prescription to get diclofenac here ;)

Kote Tsintsadze

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Michael, I had a very similar condition. It started as pain in the shoulder, and then moved down into the bicep. For two years I didn't climb, trying to get it to heal. Rest and rehab didn't make it go away. The pain was so bad that even the vibrations from riding in a car was painful. It would seem ok, and I would start climbing again, and bang, it would come right back. An MRI showed that I have a torn labrum, which irritates the tendons when the joint is too loose. Finally, the thing that really seemed to help was a lot of antagonistic training and stretching. Military press, lots of rotator cuff stuff with bands, and triceps extensions. For stretching the bicep, place your arm on a wall, with something to support it, palm facing away from the wall with the thumb down, and turn the shoulder away from the wall. The book "one move too many" has some good photos of this stretch and other good stuff. The good news is that now it doesn't bother me. I have noticed, though, that if I neglect the antagonistic training, even for a week, that the pain will start to come back.