Kinesiology THURSDAY – Bicep Tendon Dumping

Diagram of shoulder anatomy highlighting subscapularis muscle

Ever experience pain in the front of your shoulder when you reach behind you? It may happen if you are sitting in the driver’s seat and grabbing something in the back seat, or if you are putting on a coat or doing a bench press. What all these things have in common is loading of the bicep long head tendon in its stretched position.

One common cause of this is bicep tendon dumping, the mild medial subluxation of the bicep tendon out of the bicipital groove. And one of the main culprits of this is a trigger point in the subscapularis. Remember, trigger points set up in muscles that are chronically short. Take a look a this guy’s posture:

Man wearing blazer, shirt, jeans, and brown shoes.

Notice you see more knuckles on his right hand than his left. This indicates his right shoulder is more internally rotated, a position that may cause trigger points in one or more of the following muscles: anterior deltoid, pectoralis major and subscapularis.

The subscapularis has a fascial attachment to the bicep long head tendon. With chronic tightening, it may pull the bicep tendon medially and slightly out of the bicipital groove. This may be the case if there is:

Pain with resistance to shoulder flexion
Pain with passive shoulder hyperextension
Pain with palpation of the bicep long head tendon
Trigger point in the subscapularis

Here’s how to treat it:

Release the trigger point in subscapularis by placing deep pressure on the anterior surface of the scapula
Reposition the bicep long head tendon by placing lateral pressure on the bicep tendon during active or passive shoulder external rotation for three repetitions
Re-test resistance to shoulder flexion

It’s that simple.

Exercise fix:

Strengthen the scapular retractors and external rotators to correct the position of the arm at rest. Start with wall angels. (I actually have a video on this that I made myself, but this one is so entertaining, I thought I’d send this link instead). And then add over head pressing with dumbbells using a similar motion of your arms.

Why does this matter?

Insidious onset anterior shoulder pain is often due to tightness of shoulder internal rotators causing medial dumping of the bicep long head tendon out of the bicipital groove. By correcting the position of the bicep long head tendon, you may immediately eliminate anterior shoulder pain.

Give it a try. Check yourself in the mirror. Do you see knuckles? Does it hurt to reach behind you? Try this quick fix.

Because nobody has time to be in pain.

Until next time…