Welcome to Part Two of Common Injuries suffered by Massage Therapists.

Bicipital Tendonitis

Biceps tendonitis is inflammation of the long head of the biceps tendon. In its early stages, the tendon becomes red and swollen. As tendonitis develops, the tendon sheath (covering) can thicken. The cord itself often thickens or grows larger.

In these late stages, the Biceps Tendon is often dark red in color due to the inflammation. Occasionally, the damage to the tendon can result in a tendon tear, and then deformity of the arm (a “Popeye” bulge in the upper arm).


In most cases, damage to the biceps tendon is due to a lifetime of normal activities. As we age, our tendons slowly weaken with everyday wear and tear. This degeneration can be worsened by overuse — repeating the same shoulder motions again and again.

Many jobs and routine chores can cause overuse damage. Sports activities — particularly those that require repetitive overhead motion, such as swimming, tennis, and baseball — can also put people at risk for biceps tendinitis.

A repetitive overhead motion may play a part in other shoulder problems that occur with biceps tendinitis. Rotator cuff tears, osteoarthritis, and chronic shoulder instability are often caused by overuse, repetitive motion.


· Pain or tenderness in the front of the shoulder, which worsens with overhead lifting or activity
· Pain or achiness that moves down the upper arm bone
· An occasional snapping sound or sensation in the shoulder

Rotator Cuff Injury

When the rotator cuff is damaged, a variety of issues arise:
Pain and spasm limit the range of motion of the shoulder.

The muscles do not make the small adjustments within the joint to allow the humeral head to move smoothly.

Fluid accumulation within the joint due to inflammation limits movement.

There can be an impingement on the rotator cuff muscles or the tendons that attach them to the bones. The tendons run through narrow bony spaces, and if there is a change in how the humerus and scapula move, these spaces can become even narrower. Arthritis and calcium deposits that form over time limit range of motion. These calcifications may occur along the bony edges of the joint or within the tendons of the rotator cuff muscles. Chronic rotator cuff tears are typically found among people in occupations or sports requiring excessive overhead activity (examples, painters, baseball pitchers, tennis players). The constant injuries may be a result of a previous acute injury that has caused a structural problem within the shoulder and affected the rotator cuff anatomy or function (for example, bone spurs that impinge upon a muscle or tendon, inducing inflammation). Repetitive trauma to the muscle by everyday movement of the shoulder. A chronic tear may lead to degenerative changes to the tendon, leading to worsening pain, decreased range of motion, and reduced function.


Rest. The first step toward recovery is to avoid activities that cause pain. The use of a sling may be appropriate.

Ice. Apply cold packs for 20 minutes at a time, several times a day, to keep swelling down. Do not apply ice directly to the skin.

Nonsteroidal anti-inflammatory medicines. Ibuprofen and
Naproxen reduces pain and swelling.

Physical therapy. Specific stretching and strengthening exercises can help restore range of motion and strengthen your shoulder.



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