The overhead athlete oftentimes complains of distal biceps soreness. It is often diagnosed as biceps tendinitis but I think we are missing a key component.
In this example, if you palpate the biceps it appears to be sore but if you move the biceps side in palpate underneath the biceps you will reveal the brachialis muscle.
When I palpated this area, the athlete reported that that was his soreness more so than the biceps muscle.
As you may remember, the brachialis muscle is the primary flexor of the elbow which means it is eccentrically working during the follow-through phase of throwing (when the elbow is extending).
I think this is a prime example and what we commonly see in our overhead athletes when they are ramping up their throwing programs.
The moral of the story… Don’t forget about the brachialis muscle and treat it appropriately. The biceps may be involved but I often think the brachialis muscle is the primary culprit in many of these cases.
