I’ve been feeling pretty inadequate lately after seeing a Physical Therapist to help with an injury to my bicep. If you’ve never been to physical therapy it can be a really rewarding and eye opening experience. I was blown away about how a seemingly disconnected part of my body is responsible for weakness elsewhere.
The injury that sent my to physical therapy is a partial tear of the lower brachialis anticus, or a distal biceps tear, right above where it inserts above the elbow. Having an injury at this location is not common. Nearly 90% of bicep overuse injuries and tears happen in the upper portion near the shoulder. Not me, I have to be special.
It started about three years ago in my left, non-dominant, arm. I slowly developed a dull pain on the inside of my elbow which got sharper anytime I lifted anything or used that hand to open a door. When it became a constant sharp pain and started to affect my activity I finally went to see a Sports Medicine Doctor who ran me through the paces and diagnosed me with a partial distal biceps tear. Treatment was a cortisone shot, rest, ice, and deep muscle massage. It worked, and after about 8 months I was significantly weaker in my left arm but I had no more pain.
Then about a year later I started to develop the same thing in my right arm. This time, the pain was also accompanied by a sudden weakness that would occur at the most inopportune times – like when I was holding a weight over my head.
Back to the Sports Medicine Doctor who diagnosed me with another distal biceps tear along with a nerve entrapment. I tried the same treatment but it didn’t work out as well this time. More concerning is that I developed this relatively rare condition twice in two different arms. After discussing with my Doctor I decided to give physical therapy a try and I went in for an evaluation.
If you’ve never been to physical therapy before you might be surprised by the initial evaluation. Rather than focusing on your specific problem, a good Physical Therapist will give you a full body evaluation to try to determine if your problem is related to something else. I was asked to walk around, jog, jump, kneel, and sit… all so they could evaluate my elbow.
Imagine my surprise when my Therapist told my that my arm pain was coming from a weak backside. I was admittedly skeptical but when given the full explanation it makes a lot of sense. She had correctly identified a stepped spine from a lower back injury I sustained playing football years ago that I basically ignored and learned to live with. It doesn’t cause me any real pain but apparently I’ve been compensating for it by moving my body differently.
Rather than stabilizing with my back, as most people do, I use my shoulders and arms to stabilize. This means that when I lift or pull anything I’m overusing my biceps and forearms and keep opening myself up to injury. When I started working out heavily a few years ago this led to overuse and my distal bicep tears.
So, my Physical Therapist has me on a regimen of exercises and movements intended to strengthen and balance my back so that I no longer am prone to this kind of injury. It’s been a long and hard process and I have had to really focus on activating and using muscles – like my glutes – that I almost never use. But so far, it seems to be working.
My back is getting stronger and the pain in my arm has subsided significantly. My Therapist has used an Active Release Technique (that I could write a whole other post about) to relieve the nerve entrapment and I’m hopeful that I’ll finally resolve this nagging issue. But man, some of these simple exercises I am doing are hard. I haven’t used some parts of my body this way, like ever.
Hopefully I can report back in a few weeks that it’s worked!