Diagnosis Explanation:

Biceps tendonitis is inflammation of the biceps tendon, which connects the biceps muscle to the shoulder and elbow. It is commonly caused by overuse, repetitive overhead movements, or strain from lifting. Symptoms include pain in the front of the shoulder, tenderness over the biceps tendon, weakness, and discomfort with lifting or reaching overhead.

Specific Work Modifications:

• If your job requires standing or walking: Avoid repetitive overhead reaching and take breaks to rest the arm.
• If your job involves lifting: Avoid lifting objects with the arm fully extended or repetitive pushing and pulling. Use both hands when possible.
• If your job is desk-based: Keep the shoulder relaxed, use arm support, and avoid resting on the affected arm for long periods.
• Avoid: Overhead reaching, heavy lifting, repetitive pushing or pulling, and sleeping on the affected side.

Specific Activity Modifications:

• If you play sports: Avoid throwing, swimming strokes, or overhead movements until pain subsides.
• If you do weightlifting: Avoid overhead presses, biceps curls, dips, and pull-ups; focus on controlled, pain-free movements.
• If you do yoga or Pilates: Modify poses to avoid deep shoulder extension and excessive arm weight-bearing.
• Avoid: Repetitive overhead motions, heavy biceps exercises, and jerky arm movements.

Recommended Supplements:

• Collagen Peptides – 10g daily for tendon and joint repair.
• Vitamin C – 500mg daily to support collagen synthesis.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for tendon health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support tendon repair.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tendon flexibility.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support tendon recovery.

Home Exercise Prescription (Rehabilitation for Biceps Tendonitis)

Early Phase (0-2 Weeks, Reducing Pain & Inflammation):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
• Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
• Shoulder Blade Squeezes – Pinch shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
• Neck & Upper Trap Stretch – Gently tilt head to the opposite side, hold 20 seconds, 3x/day.

Strengthening Phase (2-6 Weeks, Improving Stability & Function):

• Isometric Shoulder Holds – Press palm against a wall without moving the shoulder, hold 5 seconds, repeat 10 reps, 2x/day.
• Internal & External Rotation (Resistance Band) – Keep elbow at 90 degrees, rotate forearm inward and outward, 10 reps, 2x/day.
• Wall Slides – Stand facing a wall, slowly slide hands up, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Restoring Strength & Preventing Recurrence):

• Lateral Arm Raises (Light Resistance) – Raise arms to shoulder height, 10 reps, 2x/day.
• Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
• Modified Push-Ups (Wall or Knees) – Maintain control, 10 reps, 2x/day.

Helpful Books:

1. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.
2. Overcoming Tendonitis: A Systematic Approach to the Treatment and Rehabilitation of Tendon Pain – Andrew Burns.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.