Does Physiotherapy Help Biceps Tendonitis? It's not helping mine.

by Allison

Can physiotherapy for tendonitis actually prolong or inflame it?


I have been seeing someone for about two weeks for bicep tendonitis and possibly a little tennis elbow.

After almost two weeks of friction and heavy massage as well as some acupuncture into the tendon/tendons I feel in a worse state.

I can't seem to take part effectively in the usual activities I was doing two weeks ago, such as typing.

Is this how it goes? I wasn't feeling that bad before, even though, I guess it could be considered a recurring problem as I have suffered with it for a while.

I also hadn't been told that after acupuncture I would feel more sore in the muscles for a few days when using them, so I'm not sure what to think.

Does a person usually restrict themselves from activities shortly after acupuncture?

What is the approach that physio generally takes when tackling a problem like this?

Thank you.



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Joshua Answers

I don't know what physiotherapy usually does for tendonitis, as their training and philosophy is often different from clinic to clinic.

Some do massage, some don't. Some use Ultrasound, some don't. Some believe in acupuncture, some don't.

Rest isn't necessarily indicated after an acupuncture treatment (and rest doesn't cure or fix tendonitis), but if you have an acute aspect of your Tendonitis, then it's going to flare up, period, when you do activity.

Activity adds irritation to an already irritated dynamic.

Why isn't your physiotherapy working? Maybe they're working the tissue too 'hard' and that's irritating that.

Maybe they're not effectively addressing the factors that are causing the pain and problem (clearly they're not).

I imagine that regardless of what good things they are doing, they are not adequately dealing with the inflammation process. If you don't deal with the pain enhancing effects of inflammation, when they work on you your body is going to translate that as an attack, and it will protect you with more tightness and pain.

The Process of Inflammation is an integral part of the Tendonitis dynamic.

If one doesn't deal effectively with it, no matter what kind of Tendonitis therapy you are pursuing, it is likely to fail.

And then, there's necessary nutrition, and the chronic tightness, each of those factors must be taken care of effectively.



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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
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Comments for Does Physiotherapy Help Biceps Tendonitis? It's not helping mine.

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Dec 13, 2014
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Bicep Tendonitis and tear, corticosteroid shots didn't work so had surgery
by: Lars

I have bicep tendonitis and three shots in the tendon with cortisone failed.

In surgery the major tendon was cut because it was tore so bad. This has been a year and it very hard to do anything. So what can I do the doctors say to rest it, so in other words there is nothing I can do.

After surgery my arm was in a sling for six weeks went fishing the tendonitis was back from casting the fishing pole. The doctor have no clue other than a line of B.S.


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Joshua Comments:

Hi Lars.

Yeah, doctors just don't have much for anything tendonitis related.

Corticosteroid Injections don't and can't fix any kind of Tendonitis

See: What Is Tendonitis


So. You had pain, you had surgery. You actually had a tear? Are your activity levels such that you 'did something' that could cause a tear? Or did you just get a bad tear out of the blue (which points to nutritional insufficiency and other factors...or at least, all the same factors of tendonitis but 'worse').

3. My general response is that you should get the Reversing Bicep Tendonitis ebook. It's everything your doctor should have told you and told you to do but doesn't know (which is mind boggling, but seems to be true across the board).

And, it's all the same activity you need to do post-surgery

* partly because surgery doesn't touch and of the -causes- of the tendonitis and tear, and

* partly because surgery causes certain problems that you need to reverse (which are the same factors that caused the problem in the first place: nutritional insufficiency/deficiency, too tight muscle and connective tissue, and process of inflammation).

Pre or post surgery, one must reverse the dynamic of those factors if one wants to return towards optimal function.

You've had surgery etc, you don't need a tip or a trip, you need a plan of attack so you can get your arm working again.


More questions, more answers.



Apr 17, 2017
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6 weeks PT and no change
by: kim

I have been diagnosed (via MRI) with biceps tendonitis, SLAP tear, and torn RC (50% tear on supraspinatus).

The biceps tendon is very sore and the main problem right now -- we can't seem to get the inflammation down so there is no progress for recovery. It's been 6 weeks.

My PT does HARD manual tissue work and standard exercises, I am icing it 1x per day and rolling muscles on my own; I am a personal trainer / fitness teacher by trade and while I am not at complete rest I do not do any upper body work with weights right now.

For the last 10 days even cardio is modified so that I do not use my arms (I work on elliptical with hands on railing so that there is no extra friction in my shoulder joint).

I am worried that my drs are going to suggest surgery, which i do not want to do. I was thinking of trying acupuncture. I am in desperate need of suggestions!!!!!


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Joshua Comments:

Hi Kim.

1. If you have a 50% tear in the supraspinatus tendon, you may want to reconsider surgery.

The SLAP tear may or may not be fixable via surgery, depending on what a surgeon would assess.


2. Having said that, the tears happened for reasons that your PT and doctors and surgeons will never talk to you about (which are the same factors that make up the Tendonitis dynamic.

These same reasons are why you're not having success with the 'hard' manual tissue work and stretching etc.

The tears (and tendonitis) are symptoms of underlying factors of dysfunction....and there's good reason why the inflammation won't dial down.

And while sometimes surgery is necessary to reattach torn tissue...if those same factors are in place when you get surgery, your recovery will be iffy at best.


3. Icing 1x/day (presumably for 20 minutes) when you have such a severe injury dynamic in place is so incredibly insufficient you might as well not even do it.



4. I suggest that you get and start working with my Reversing Shoulder Tendonitis program.

While it contains more that you need to do, it's worth it if only because it covers the nutrition that you're short on and that is required for your muscles to A. relax and B. work properly (being short on it is part of why you're where you're at, and is required to get out of where you're at) and C. is required to get any benefit from the massage your PT is doing, and the nutrition that is required to help your inflammation process be able to dial down, etc.

You have actual tears. The tears themselves trigger tightness and inflammation, so that's a problematic factor. But again, the tear is a symptom of something, not the causative problem.

Right now your focus is on A. getting your tissues/systems ABLE to work correctly again, so your body can B. dial down the tightness and inflammation.



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