Monday 21 October 2019

Training wIth injuries - Long head of biceps

The following is my personal experience in how to adapt to a difficult injury to recover from, that of the long head of the biceps.

Table of contents


From October to December 2017 I felt a growing niggling in my left shoulder. Just before Christmas it got bad. Turned out the long-head of the biceps was inflamed where it passed over the humeral head. This injury was caused by overuse and due to several factors would ultimately take about a year and half to fully recover from.

Thankfully I already had a hospital physio appointment coming in January 2018 to do with a different injury in the same area that had long since healed. Whilst they helped and put me into a rehabilitation class for 6 weeks the pain just didn't go away.

In the end I went to a private physio who advised me that I shouldn't have been put into the rehabilitation class until the inflammation had gone away and the fact I was still feeling pain in the area during and after it meant I still had it.

The National Health Service (NHS) is free here in the UK, which is great, but in regards to musculo-skeletal injuries they get it wrong quite a bit and a private physio is worth paying in many cases.

Picture from Cleveland Clinic.

The physio told me that I could not do any exercises that involved overhead actions until the inflammation had gone and I slowly built up to it again. True enough, even the simplest overhead actions aggravated it. I couldn't even bring my arm to parallel for the first couple of months due to the pain. Any form of quick tempo or ballistics was also banned.

As my routine was bodyweight based and many of the exercises involved arms overhead or some form of activation or stretch of the long head of the biceps (support holds and deep dips) I was devastated. I had to stop performing certain exercises that formed a considerable chunk of my training.

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The weights conundrum

Prior to this injury I had for some time contemplated adding weights back into my routine, and I had started this with the addition of weighted squats. Only my pride stopped me at that time from fully implementing this course of action.

This injury however meant I had to fully embrace doing weights again if I wanted to maintain my lats, shoulder and triceps strength seeing as I could for the foreseeable future not perform pull ups, handstands or dips.

Whilst not perfect I started to perform several exercises that helped me maintain a degree of strength in my lats, shoulders and triceps. I was quite surprised to discover just how much strength I had developed from only doing bodyweight exercises. Case in point was being able to perform straight away in a strict controlled manner narrow grip cable machine rows at 100kg!

So what where the exercises I needed to implement?

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Latissimus dorsi exercises

Unfortunately the best exercises for the lats are overhead ones which were prohibited, but there are some that helped:

  • Seated cable rows - Having the cable set to stomach height with a narrow parallel grip handle helps target the lats more than the upper back muscles (rhomboids etc.). Video of exercise: How To: Seated Low Row (LF Cable).
  • Seated machine row - Placing the seat higher up and gripping the inside bars so that your hands are parallel to each other helps shift more focus onto the lats. Video of exercise: Seated Row/ Seated Row Machine.

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Triceps exercises

The triceps push down machine and diamond presses were prohibited as they aggravated the injury. This left very few options however the following worked well:

  • Skull-crushers - Whether with a dumbbell or barball, simply have your upper arms a degree or two closer towards your mid-line than vertical with the floor to help stop engaging the long-head of the biceps. Whilst this is not the optimum arm position for this exercise, it helps bypass this kind of injury. Video of dumbbell version of exercise: How To: Dumbbell Skull Crusher
  • Triceps kickback - As long as you aren't extending your arm too far beyond your back then this shouldn't aggravate the injury. Video of dumbbell version of exercise: How To: Tricep Kickback (Dumbbell)

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Shoulder exercises

For pressing strength the shoulders ideally require overhead exercises, but the following "pulling" exercises helped. Simply ensure you keep your arms to parallel or below. It also helps to keep the weight lower than you would wish at the start. Whilst this is not optimum for maximum benefit we can't afford to keep the injured area inflamed.

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As my other job involves quite a bit of arms up and carrying items, the injury did take longer to heal. Add in the fact I did prematurely try some overhead stuff when I thought I was in the clear only aggravated it all. Thus it took a good year and half for it to fully heal. Yet had it not been for those weighted exercises I would have lost all the strength I had gained in my lats, shoulders and triceps.

There are no doubt other exercises that would help as well, however these are bread and butter weighted exercises in many peoples routines and work great.

If you have any questions or want advice on an injury workaround then feel free to ask away in the comments or send me some feedback!

Lyle Richardson,
Gym Pal - Your Friend In Fitness


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