Hi Fellow Physio's,

I am wondering for some advice for a lady that I seen in clinic today.

35 years ole fit and healthy regular gym user. Desribed pain down lateral left upper arm from shouler tip to just above elbow, desribes pain as sharp with movement and sometimes absent at rest though it can ache if done lots of aggravating activities. Onset 4 weeks ago, question as to onset and cannot think of anything different in her life that could have contributed. Reports hurts putting coat on, hurts changing gear in car, hurts even to push a button. Has quite a physical job as an engineer fixing hosp machinery.

Wanted to rule out neck so tested and she had full pain free movement and no Hx of neck probs. There was tightness left upper traps with side flex to right.

A history of LBP that the lady says completely gone through her trans abs contract when running.

Full pain free mvt of unaffected right arm and shoulder.

Symptomatic left shoulder at 90 degrees shoulder flex gets pain but can go further to get pain free and achive FROM.

Ext at shoulder reports no pain. Hand behind head can manage but not push elbow back due to pain.

Full muscle power resist bicep, tricep tested with elbow tucked into waist. Lat rotation causes sig pain, nil with resist medial rotation.

Special tests: full can empty can produces pain

Palpation of aromion and around is tender to touch and some pain in pec Major/minor.

On further questionning we established that she had begun a routine of bicep curls using weights in the gym around 4 wks ago.

My thoughts are that there is damage to the biceps tendon or transverse lgt.
What is the time frame for healing in this and does this sound like a correct diagnosis?The Pt then had her arm aching after all the tests.

I massages the region within tolerance and applied US. I gave her some stretching exercises but very gentle ones.

Are there any good treatments for this injury or exercises? what are the prognosis in these injurys and what should be avoided?

Hope someone can advise, thanks Njorl

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