Physiotherapy plays a central role in the treatment of biceps tendon inflammation. Since the inflammation is usually caused by overloading or incorrect loading in combination with a too weakly developed musculature of the rotator cuff of the shoulder joint, physiotherapy aims to eliminate these problems. In addition, there are various pain management options in the course of therapy to provide patients with quick and long-term relief from their symptoms. The contents of the therapy always depend on the individual situation of the patient, as well as the type and extent of the biceps tendon inflammation.
Contents of the physiotherapy
Physiotherapy plays a central role in the conservative treatment of biceps tendon inflammation. The primary goal of physiotherapeutic treatment is to relieve the patient of pain and restore full joint mobility. To achieve this, there are various therapeutic approaches that can be considered for treatment.
Often a combination of several elements is tailored to the individual patient. An individual treatment plan is drawn up for each patient, which is specially tailored to the needs of the patient.
- Cold applications ensure that the pain is alleviated and the inflammation is fought.
- Relief of the biceps tendon through targeted strength training for the muscles of the rotator cuff of the shoulder joint.
As well as stretching and stabilizing exercises that increase the freedom of movement of the shoulder joint. The patient is given exercises that can and should also be performed on their own after the end of the therapy to prevent a renewed inflammation.
- Manual therapy in which the musculature in the shoulder area can be loosened using various grip techniques, as well as passive mobilization exercises in which the shoulder is moved without the patient’s assistance.
- Cross friction. This is a special massage technique in which the biceps tendon is massaged without the patient feeling pain.
The cross friction has the goal to stimulate the local blood circulation and is only indicated in case of an inflammation of the tendon.
- Ultrasound and electric current applications to stimulate the muscles and promote the supply of nutrients in the shoulder area.
- The application of a classic tape bandage or kinesiotape to stabilize and relieve the biceps tendon.
Since biceps tendon inflammation is an inflammation, cold is often pain-relieving here. In the acute stage a moderate cold, about 8-10 degrees, should be applied to the shoulder for about 1-2 minutes. This is followed by a break in which the tissue recovers from the cold.
Blood circulation is increased, lymph drainage is enabled, and healing is supported. Too long cold stimulation can limit these processes. In the treatment of chronic or protracted inflammation of the biceps tendon, short, violent cold stimuli (e.g. ice lollipops) can also be used.
In most cases, the application takes place in alternation with intensive massages (friction) of the tendon. The cold has an anaesthetic effect. Even if the vessels are narrowed by the strong cold stimulus, there is a compensatory increase in blood flow afterwards, so-called reactive hyperemia, which is conducive to healing.
In principle, cold can always be used if it is perceived as pleasant. Cold therapy is particularly recommended for acute inflammations, while warmth is often perceived as more pleasant in chronic cases. In the context of the manual therapeutic treatment of biceps tendon inflammation, not much is initially done in the acute interval.
Possible blockages of the spine, which can affect the biceps tendon through nerve irritation, are treated, but the shoulder itself is initially left out of the manual therapy. Later, after healing or surgery, the mobility of the shoulder can be restored in manual therapy for biceps tendon inflammation by joint techniques. To do this, the therapist grasps close to the joint and moves the joint head of the shoulder in the glenoid cavity of the shoulder blade.
This mobilizes the joint surfaces and improves the function of the joint. The active movement is developed and maintained by the patient practicing independently. Manual therapeutic soft tissue treatments are used in addition to active and passive mobilization in order to mobilize and support the tissue that may be stuck together.In spite of all therapeutic techniques, therapeutic success in manual therapy is also dependent on the active cooperation of the patient in the long term.
Transverse friction is a massage/stretching technique that is very important in the treatment of tendons. The therapist places his fingers on the tendon and exerts relatively strong pressure in the depths. He then pulls the tendon slightly to the side, causing it to stretch slightly.
The punctiform pressure can sometimes be very unpleasant for the patient, therefore, as described above, a violent short cold stimulus is often used as an “anaesthetic”. The transverse friction is performed over about 10 minutes with pauses. The treatment area may still feel painfully irritated the next day.
In the long term, the therapy is perceived as very pleasant and pain-relieving. The advantage of the therapy is that pain points and problem areas can be treated very precisely. Through the cross friction a stimulus is set, similar to an inflammation.
This increases the blood circulation, attracts cells of the immune system and promotes healing. Transverse friction may only be applied to soft tissue (tendons or muscles). Performed on bones, an inflammation of the periosteum can be caused.
Ultrasound and electrotherapy can also be used to treat tendons and muscles. These are sound waves of different frequencies, or different forms of current, which pass through the tissue and cause a specific effect there. Both alternating and direct current applications are used in electrotherapy.
Depending on the form of application and frequency, the currents can have a rather pain-relieving, blood circulation-enhancing or even relaxing effect on the muscles. Ultrasound creates heat in the tissue, the transducer must remain in motion during the entire treatment. The heat penetrates deep into the tissue, where it increases the blood circulation and relaxes the muscles.
Even pain points in the tendon area can be treated in this way. If necessary, a medication can be applied during the application of sound or electricity, which should then be introduced deeper into the tissue. Voltaren (Diclofenac) is often used.
In this context one speaks of iontophoresis. Tape bandages can be used for biceps tendon inflammation. While the classic tape is used more as a stabilizing bandage, the kinesiotape is intended to support healing through targeted application without immobilizing the joint.
While the classic tape is usually white, the Kinesiotape is available in different colors. The color of the tape plays an important role in the selection, the red tape should have a stimulating and warming effect, while the blue tape should have a relaxing and cooling effect. Green on the other hand is a neutral color.
Which system is the right one for the patient should be discussed with the therapist or the doctor during therapy.
- Classical tape is therefore used especially in the acute area when the tendon is to be relieved and protected and immobilization is indicated.
- Kinesiotape systems for the shoulder and the biceps tendon can look different and can be tailored to the specific problems of the patient. The mechanical irritation of the skin is intended to promote blood circulation and the healing process in the underlying tissue.
The muscles are also influenced by the tape. Hypertonic muscles, i.e. muscles that work too hard, can be relaxed and weak muscles stimulated by the tape. A slight relieving, protective effect is also said to be due to the Kinesiotape.
