I’m trying to figure out if my elbow injury is a distal biceps tendinopathy. Pain is below the elbow, mainly on the inside. It’s more soreness than sharp pain.
Approximately two months ago I injured my arm setting down a dumbbell. It immediately hurt and the inside of my elbow quickly turned black and blue. I don’t believe there was any impact. I tried to do some chinups, which were next on that day’s programming, but even one hurt too much.
A few days later I tried chinups again and could do a few before the inner elbow started hurting. The pain went away quickly.
I thought the issue was golfer’s elbow, but wrist curls, which seem a standard rehab, don’t hurt at all. Arm curls do hurt, which leads me to believe the issue is the biceps tendon. Hammer curls are relatively easy, but supinated is definitely noticeable, as are other curling related movements, such as cable or machine rows. All of the foregoing has been limited and done mainly as a test. I’ve also been doing chinups every couple of days. I can do a few before they start hurting and the pain had been going away quickly.
Pain has been increasing recently, even in the absence of exercise. It continue to be mainly on the inside of my ellbow, often on the pinky side but not entirely, and always below the elbow. Also, the area below the outside point of the elbow has started to hurt occasionally.
Does this sound like a distal biceps tendon issue?
BTW, I’m familiar with BBM’s materials on pain and on tendinopathy.
I’m not sure we will be able to confidently figure this out via the forum. I’m also not sure how our answer either way regarding a diagnostic label would change what you do here, practically speaking. If you feel that things aren’t resolving at this point, it’d probably be best to pursue a consult.
That sounds correct. I had just thought the problem was a medial forearm tendon, but given the feelings I get from trying various exercises, it seems to be the biceps tendon. I also find it odd that the outside elbow has started to hurt.
The difference for treatment would seem to be doing exercises appropriate for the biceps tendon (curl type exercises) rather than for the forearm tendons (wrist curls and reverse wrist curls), but that’s likely just quibbling.
A general rule of thumb can just be that the exercises you do should engage the affected/symptomatic area, i.e., be “provocative” in a tolerable way. This is how I think about it in my own training, without paying any attention to the specific anatomic structures I think may be implicated.
That’s what I’ve been trying to do. So far, hammer curls have been the best combination of provocative and tolerable. Slow chinups are also tolerable and provocative, but I worry that I’ll overdo, especially since the line is at a much lower number of reps than I can do with DBs.
I do note your frequent statement that diagnosis is useful only if it affects the course of treatment.
I’ve been doing some of those. So far they haven’t hurt at all (perhaps 0.5 on a scale of 10), although I’m now at about 85% of my usual lat PD weight. Oddly, even very lightweight cable or machine rows are not really tolerable. I haven’t tried one-arm DB rows yet.