Anterior Elbow Pain From Biceps Tendinopathy

Middle Aged Men And Anterior Elbow Pain

Biceps tendon injuries causing anterior elbow pain are relatively common, however the majority of tendon injuries involving the biceps muscle occur in the proximal tendon at, or near its origin at the shoulder. In the shoulder the tendon can suffer tendinosis, tenosynovitis as well as tears and even complete rupture of the tendon occurs somewhat commonly. With regard to the biceps tendon at the elbow, tendinosis is the most common cause of pain, or functional limitation. Rupture of the distal biceps tendon at the elbow is significantly less common than the equivalent shoulder biceps tendon tear, or rupture, yet exact statistics regarding the frequency of distal biceps tendinopathy causing anterior elbow pain is unknown. As far as elbow tendinopathies are concerned bicep tendon pain is considerably less common than a couple of other tendon complaints at the elbow such as; tennis elbow or golfers elbow.

Some statistics regarding anterior elbow pain from biceps tendon origin:

• Distal biceps tendinopathy is reported to be a condition more commonly associated with men in their forth decade. With injury typically occurring in males aged between the ages of 30-60 yrs old. This is not dissimilar to most other tendinopathies in the body that also are more common in that middle, to late middle age bracket.
• Again similar to other tendinopathies, smoking has been reported to increase the risk of developing distal biceps injury causing anterior elbow pain, increasing the risk up to 7.5 times compared to that of non-smokers.

From my own personal experience as a physiotherapist practicing for over twenty years, my findings would support the above. I am still yet to treat a female with the condition and not all but certainly the majority of patients I have treated in our Sydney CBD physio practice for anterior elbow pain from biceps tendinopathy have been aged between 35-50 yrs old. The few falling outside that age bracket were young males in their late 20’s heavily into weight lifting.

A condition becoming more common over time:

I would suggests that anterior elbow pain from biceps tendon origin is a condition at least in my experience that is becoming more prevalent over the years. In the last 10 years I have seen an increase in the number of patients presenting for treatment of a biceps tendinopathy. My rational around this is that over time resistance training has become more common place among the aging athlete. Where as previously weight training at the gym was more a young mans game and people tended to give weight training away once they leave their twenties, what I am seeing in the general population attending the clinic for treatment these days is that resistance training as a part of an exercise regime is common place in individuals in their 4th decade and beyond. Not only this, but there is also higher percentage of individuals in this age group doing high intensity training using compound movements which may potentially suggest in training they are taking their body closer to failure. And using non-isolated movements that can put increased demands on tissues as they are required to control greater motions under strain.  This approach to training in middle aged athletes and beyond may put them at risk of tissue overload and injury to the distal biceps tendon.

Please Note: The above are purely observations from my practice as a physio working out of a CBD physio clinic they are not based on research, or necessarily reflect the thoughts and findings of the wider physiotherapy community.

Distal Biceps Tendinopathy Signs And Symptoms

Pain is the dominant symptom with distal biceps tendinopathies, with patients reporting that they experience pain in the front of the elbow. The pain sensation with mild conditions may simply be an ache in the front of the elbow and/or a sensation of stiffness at the elbow. Discomfort is likely to be more noticeable during, or following activities which require strong, or repetitive contraction of the biceps muscle. Common exercises or activities that can cause distal bicep pain at the elbow include; carrying heavy shopping, performing weighted biceps curls, or performing chin ups…
In more severe cases, the anterior elbow pain will be sharp and limiting causing a total cessation of pain provoking activities and impacting more simple day to day actions like cleaning, or cooking. Occasionally swelling around the biceps tendon at the front of the elbow will be present and the area will be tender to touch, with firm pressure to the tendon itself.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Anterior Elbow Pain From Biceps Tendinopathy should consult his or her general practitioner, sports medicine specialist, orthopedic surgeon, physiotherapist or otherwise appropriately skilled practitioner.