Three Biceps strengthening exercises to improve range of motion.

Biceps is an important muscle in the human body. We use this muscle to perform many activities of daily living. In addition, biceps holds its crucial place cosmetically. It is the muscle that gives the look of “masculine build”. This is created by biceps strengthening to create hypertrophy of the muscle. And therefore, it may not be the largest or the biggest muscle but surely it is one of the most important muscles of the human body.

Anatomy of Biceps :

As the name suggests, biceps muscle generally has two heads. It originates from the scapula (shoulder blade) and humerus (long bone of the arm). It inserts into the inner bone of the forearm (ulna). In the human body, this muscle is found to have three heads and sometimes even more. Therefore, biceps is considered probably the most variable muscles in the human body.

Action of the Biceps

Biceps is the main elbow flexor. In other words, it bends your elbow. Thus, biceps is the main antagonist of triceps.  Since biceps is a biarticular muscle, it also assists the movement of the shoulder like shoulder flexion and abduction.

Clinical Indication for Biceps Strengthening:

Injury or a tear of the biceps muscle is common. a clinician needs to reduce pain, swelling and improve the range of motion prior to performing strengthening exercise after an injury to the muscle.

1. Biceps Tendonitis – This is the most common injury to the biceps tendon.
2. Fracture of humerus either the head or shaft of the humerus causing injury to the muscle. The type and the severity of the injury depend on the type and severity of the fracture. For example, a dislocated bony part of the fracture can pinch into the biceps tendon. This bony fragment can make the muscle tear more severe.
3. Muscle tear: this can be at proximal level (at the shoulder) or at distal level (at the elbow). The tear can be partial or complete.
4. Radial nerve injury above elbow: Since radial nerve innervates biceps muscle, injury to the radial nerve can affect this muscle. Depending on the site of the injury and type of injury, the muscle can be completely or partially paralyzed. The nerve can be damaged at brachial plexus level, or at the humerus level.

Biceps strengthening:

There are several ways to strengthen the muscle. A physical therapist will determine a type of strengthening exercise based on the current muscle strength, patient’s goals as well as any other clinical/ medical diagnosis that a patient may have. The exercise regime will be different for a healthy person trying to achieve muscular strength/hypertrophy versus a person trying to improve range of motion.

For a person with an impaired range of motion of a biceps, a therapist will choose to perform passive range of motion initially. There is no weight applied and range of motion is attempted in either gravity eliminated plane or with the assistance of gravity.

Progression from the passive range is to an active-assisted range of motion. A therapist will ask a patient to perform active range of motion in gravity eliminated plane initially. The figure below shows elbow flexion in gravity eliminated plane. Initially, a therapist may have to assist the range or just support the body part. Here, a person is lying down with shoulder abducted to 90 degrees.

 

One can perform the same exercise in the sitting position. Maintaining a proper position while sitting for this exercise can be tiresome for a patient.

A clinician will add external weight when a patient is able to perform a full range of motion against gravity with no pain or discomfort. External weight can be in the form of a manual resistance from a physical therapist, dumbbell, T band, weighted ball or any other equipment. One can also use a can of soup, bean bag or other household items as an external resistance.

Whole Body Exercise working on Biceps strengthening:

it is also possible to strengthen the muscle with whole-body exercises like aerobic exercise. Since this muscle helps with many activities of daily living, one can choose to perform whole-body exercises to strengthen the biceps muscles as well. Examples of these exercises are push-ups, planks, side planks, Yoga, etc. Most aerobic exercises work on the whole body and therefore also works to strengthen the biceps muscle. The key point to remember here is that isolated strengthening of the muscle is more important when there is a weakness or an injury to the muscle. Aerobic exercise works on different fibers of the muscle (slow-twitch fibers) and so it improves more of the endurance of the muscle than the strength of a muscle.