Possible Brachialis strain?? Please help

[wjs010]

Hello, I'm about to be a DPT student in the US and am really glad I found this forum. Hopefully there is an iphone app so I can stay in touch. So my question: last november I was bulking a bit, probably 9-10 kg in a short period of time. I went to the driving range to play some golf and i didn't stretch or do any warm up like an idiot. Well, I felt an instant snap where my arm pit was and it felt like a tendon or something. It really may have been a slight sprain in the prox biceps tendon, but i don't know. The pain would obviously proceed if I tred to swing again. It was mainly in my arm pit and under my biceps brachii, so maybe the brachialis. There was NO discoloration. My GF is a PT luckily and she iced me and such, but there wasn't really anything we could do after that. I went to the gym the following week and hammer curls ( palm neutral) really hurt, where as supinated, regular curls didn't at all.. It was very strange. I don't know what happened and It pissed me off because I'm just a poor student..I don't have the money for an MRI, so I have to self rehab . ha! So I really look in the mirror and I can feel that the bicep is smaller, and there is a slightly less peak of the biceps upon contraction. I haven't totally gained confidence in lifting really really heavy with that bicep even now, so I lift carefully. But, it's a shame I couldn't get an MRI. Does anyone know what this may be? I don't know if something is causing it to not grow or what...?? ( I'm a bodybuilder and this may affect competition). A week or so after the injury, I was bench pressing light weight to make sure my arm pit still hurt and it did. It tells me there is something connected with the brachialis and the armpit pain. If someone could please shed light on similar events that may have happened in golf patients I would be greatly appreciated. It's been bothering me for months...and the stagnating hypertrophy is frustrating as well. So far, nothing wrong with the distal portion of the bicep. Mainly the short head, brachialus, and formerly the arm pit ( no arm pit pain anymore)

Some cliff notes:
- Swung golf club
-Immediate pain in arm pit, left bicep ( mainly outer biceps short head, or under where the brachialis is)
-that night, swolen, but I iced it.
-in the gym, pain upon hammer curls, but not regular curls
-slight decrease in bicep peak, but not too much
-seems like a slight loss in size
-can't tell if it's a muscle strain, or tendon sprain trying to heal itself and inhibiting the muscle to grow properly...

Any expert knowledge is appreciated. Sorry for the lengthy post, but I googled this and i cannot take another " tendonitis" answer on yahoo! . Please help!

---------- Post added at 12:22 AM ---------- Previous post was at 12:17 AM ----------

I would like to also point out that it sucks how expensive MRI is here in the good ole' US. I imagine it is different elsewhere.

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[bikelet]

Hi there,

Just a quick reply- you may want to consider subscapularis as a muscle which may be involved. This is a muscle which sits deep in the armpit and the tendon of which has close attachment (proximity) near the biceps tendons. See if you can get your GF to palpate the lesser tubercle of the humerus (where this muscle attaches) and also deep in the armpit. If you have a look at the link below, you can see the anatomy a bit clearer and also there is information about an injury test procedure.

Subscapularis muscle - Wikipedia, the free encyclopedia

I think subscapularis might be involved due to the location of symptoms and also because it is involved with internal rotation, particularly when the arm is outstretched (as in golf). Also consider coracobrachialis- this muscle attaches to the coracoid process (you can palpate this area/get GF to)- it doesn't cross the elbow joint, but it also helps to adduct the arm (as in the golf swing).

I wouldn't be too hung up about getting an MRI- functional and clinical testing can often tell you just as much. Good luck- let me know how you get on

[wjs010]

wow man thanks for that! I feel that it may have had some initial involvement in the pain, but I don't think its that. I need to add that the lower ( deeper, not distal) layer of my biceps brachii seem to have a more narrow appearance now, whereas before it was thicker. And the subscapularis would not have had anything to do with the hammer curl discomfort, would it? I feel that the injury was more due to forced adduction( because my chest was much bigger and i was not flexible) instead of internal rotation. I hope I have made sense with my description. If you have any other advice I would appreciate it.

[bikelet]

Hi, I just read back through your post and think that you are probably right- if that's the location that gives you pain and its quite isolated with hammer curls then it most likely is brachialis. I would say that you best bet is to begin a gradual strengthening rehab program- so start with the hammer curls but at a weight that you can tolerate with absolutely no pain and with high reps. You can gradually progress from there Also try some internal and external rotation exercises with light resistance (eg theraband or 1-2 kg wts) in case there is some rotator cuff damage.

[RyanSnell]

Yeah strip the weight off lighted reps. If you are training biceps, switch to a neutral grip curl or pronated grip curl, as this will not activate the biceps brachii as much.