Geschatte leestijd: 5 minuten
Anatomy of the upper arm and biceps
The biceps is a two-headed muscle, hence the name bi-ceps. It runs from the bottom to the top in two heads, which are connected to the shoulder joint with two attachments, the ‘proximal’ attachments, the attachments of the muscle closer to the heart.
At the bottom, the biceps is connected with an attachment to the radius bone. From this attachment, ‘distal,’ the attachment farthest from the heart, a second attachment of a different type runs, the bicipital aponeurosis, also called lacertus fibrosus. This is an attachment that fans out in a thin membrane. While the function of the normal attachment is to connect the muscle to the bone, the function of the bicipital aponeurosis is mainly to strengthen the so-called cubital fossa. Cubital refers to the elbow, and fossa refers to a depression in the body. This is a triangular area at the front of the elbow. This membrane protects the brachial artery and median nerve that run underneath it. Finally, it distinguishes between superficial tissues and deeper tissues. I will not further address this because complaints caused by the bicipital aponeurosis are experienced in the forearm and will be treated separately.
Distal tendonitis as a biceps injury
Biceps injuries and pain complaints of the distal attachment are largely caused by the attachment to the radius bone. This is the attachment that pulls on the radius to provide flexion, bending of the arm. The three most common problems are: Tendonitis, tendinosis, and a rupture (tear).
Tendonitis is an inflammation of the attachment. In the past, inflammatory complaints of this attachment were therefore treated as tendonitis. However, it is now clear that, in the case of the distal attachment of the biceps, tendinosis usually precedes this inflammation. Tendinosis is degeneration, or decay, of the attachment. This decay can then lead to inflammation of the attachment. So, there is often both.
Causes of tendinosis and tendonitis
Both are caused, among other things, by overuse, too many repetitions, or too much load. For tendinosis, there is also the theory that increased levels of growth factors cause the fibroblast cells to produce more Type III collagen than Type I. In practice, it is probably a combination of both because it is thought that it was the load that caused more growth factors and that these growth factors react differently to damaged cells than to normal cells.
Other causes include: Congenital genetic differences, reduced recovery ability due to previous trauma, and abnormal levels of proteolytic enzymes. These last ones help break down and rebuild proteins during collagen synthesis. The only cause over which you can exert influence is therefore the load.
Rupture, a torn distal attachment of the biceps
Like the proximal, upper, attachments of the biceps, the distal attachment can also tear. Just like with the proximal attachments, this can lead to a so-called ‘popeye muscle.’ Because the attachment at the bottom snaps off, the muscle bundle rolls up, as it were, causing a thick bump to be visible. A rupture can be surgically repaired by reattaching the attachment to the radius bone. Recovery within 6 weeks is possible, at least recovery to normal function. However, any connoisseur of bodybuilding classics knows that this has ended careers in many cases (including Dorian Yates and Berry de Mey) or at least messed up your schedule and plans pretty badly (Jay Cutler, Olympia elections 2011).
Treating inflamed attachment
As for attachment problems in general, you start again with R.I.C.E., Rest, Ice, Compression, Elevation. Especially the first two are important for the distal attachment of the biceps. Stopping training the biceps and, to some extent, training the back as long as the complaints persist, is the simplest and most difficult step. Cooling daily with a compress or other alternative can offer a lot of results. Another method you can apply is gently massaging the attachment. It may take a while to find the right spot. With the tip of your thumb, apply light pressure and make small circles. This promotes blood circulation and removal of waste products.
Preventing biceps injury
Now that you know how crappy it is not to be able to train your biceps (and possibly even your back) due to attachment problems, or worse, you naturally want to prevent repetition. The most important points are preventing overload and correct training form. You prevent overloading, among other things, by not increasing the training intensity too quickly, both in terms of volume and intensity (number of repetitions and weight). You do this by taking various factors into account.
- Ensure a good training schedule with sufficient rest and recovery time built in by a proper distribution of muscles to be trained. As a rule, you can assume that muscles need 48 hours of rest before you directly load them. That means training as so-called agonist by doing exercises where that muscle is the most important for the execution of the exercise. And 24 hours before you train them indirectly, as a so-called synergist, the muscle that helps with the execution, like biceps during a back workout or triceps during a chest workout. However, this depends on many factors: Fitness level, intensity of training, amount of sleep, nutrition, etc. It is good not to take less rest than this rule of thumb, but also to listen to your body. Sometimes you will feel that a certain muscle group has not rested enough. Wait a little longer with that muscle group by doing something else. Attack muscle groups that often get less attention, like forearms or the neck, for example.
- A good warm-up. As described in the article on attachment problems in general, a warm-up through cardio is recommended. A warm-up of 8-10 minutes at 60-70 percent of your maximum heart rate (220-age) provides, among other things, an increase in body temperature, resulting in the production of synovial fluid, lubricating the joints. In the shoulder, this can prevent compression that can lead to an inflamed attachment (proximal, long head of the biceps or the muscles of the rotator cuff). For attachments, a warm-up is also useful because it improves blood circulation and thus the supply of nutrients and removal of waste products. In addition, you can do a specific warm-up for the muscles you are going to train or focus your general warm-up on them. A good specific warm-up for the biceps is, for example, 21s. As a general warm-up, you could choose to row or use the cross trainer instead of the bike or treadmill so that during the general warm-up you also warm up the biceps (and back) specifically. In general, it is always wise to perform the first set or two with low weight and high repetitions. Slow repetitions where you slowly activate the muscle over the full range also work well (also with low weight).</ li>
- Correct tempo and attention to the negative part of the exercise. With bicep curls, you often see guys who grab a weight that is far too heavy, throw the weight up with their whole body, and then let it fall down again. These sling monkeys skip half of the bicep exercises by not lowering the weight in a slow controlled manner. By letting the weight down in about 3 seconds, you also force yourself to perform the negative part of the exercise. The concentric part (bringing the hand up in this case) can be faster, 1-2 seconds. For attachments, it is better because otherwise, they get a jerk every time you throw the hand up. Moreover, the weight is often too heavy then. If the weight is too heavy to lift it up in a controlled way with just the biceps, it is already too much for the attachment! Moreover, by slowly lowering the weight, you train the eccentric part of the exercise much better, which leads to more hypertrophy, a form of muscle growth, than the concentric part.
- Train the biceps over the full range. Most tension on the attachment occurs when the arm is almost straight and you want to bring the hand up again. This is also the point where the exercise is the most difficult due to the large leverage. You often see that guys who train with very heavy weights make a very short movement and keep the arm pretty bent all the time. This may feel comfortable because you relieve the attachment and can hit it hard with heavy weights, but it prevents the lower part of the biceps, including the attachment, from being trained, making them not stronger. Therefore, use your warm-up and first sets, which you often already take a bit lighter (if you train according to the pyramid system), to train the biceps over the full range. 21s are so popular precisely because they force you to give equal attention to every part of the biceps.
