The biceps brachii is a two-headed muscle whose heads’ originate on the shoulder blade (scapulae) and insert into the upper forearm. It is a strong elbow flexor (bending of the elbow), supinator (rotating the forearm so the palm faces up), and shoulder flexor.

Unfortunately, injuries often occur to the long-head of the biceps and labrum in the forearm. Catching yourself while falling, experiencing high forces from activities such as baseball pitching, or lifting heavy objects are common causes of bicep injuries.

What Type of Muscle Strain Do You Have?

Distal biceps pathology is categorized depending on the extent of the injury and the inclusion (or lack of) active inflammation in the area.

Grade I muscle strain

This consists of only minimal damage to muscle fibers, with no noticeable swelling/bruising, minimal pain to stretch and palpate, and good strength during testing.

Grade II muscle strain

The next grade has significantly more muscle tearing. Grade II features noticeable bruising/swelling in the area, weakness and pain to muscle strength testing, significant pain to palpation, and limitations in your ability to stretch the muscle.

Grade III muscle strain

The last grade is a complete muscle tear, with obvious bruising/swelling and significant strength loss in the elbow.

Before You Stretch

Early treatment after biceps muscle strain (grade I or II) consists of rest and ice to the front of the elbow. Elevating the arm above the head while resting will also help decrease the amount of swelling that occurs in the arm.

After the first 24-48 hours, beginning to comfortably use the arm is warranted to prevent muscle wasting from inactivity. If the activity causes significant pain or swelling in the front of the elbow, or causes you to compensate in the way you perform the activity because of pain, termination of the activity is appropriate until the pain and function improve.

How to Safely Stretch Your Biceps Brachii

When you’re able to use your arm for small activity, it’s time to start stretching.

  • Stand with your back facing a counter, and put the back of your hand comfortably up on the counter with your arm straight.
  • Stay tall, and gently shift your weight forwards, while keeping your arm straight, extending your shoulder. Go until you feel a good stretch and only mild discomfort in the elbow, and hold for 20 seconds.
  • Repeat this stretch three times, multiple times per day, going further as your shoulder loosens up.

Strengthening Your Biceps

To begin strengthening the biceps, it’s good to start with elbow flexion isometrics, where you are activating the biceps muscle without actually taking the muscle through a range of motion, which is less stressful.

  • Bend your elbow to 90 degrees
  • Resist further bending with the opposite hand and hold for three seconds, with no pain but only slight discomfort elicited.
  • Perform at different angles to target different portions of your bicep.
  • Perform this 10 times, for 3 sets, twice daily

When you these exercises become more tolerable, slowly add weight with dumbbells. Eccentric strengthening of the biceps (slow controlled lowering of the arm) has been shown to be the ideal way to re-strengthen muscle tissue after injury.

If you have injured your arm or are experiencing arm pain, contact your physical therapist or Life’s Work Physical Therapy. Biceps tendinopathies heal well with proper treatment, and a qualified therapist will provide a detailed evaluation of your body to determine what structures are involved and get you on a treatment plan towards recovery. Early identification and treatment allow for quicker recovery, while minimizing the effects of inactivity, compensatory patterns, and scar tissue formation in the injured muscle from poor healing of tissue.


At Life’s Work Physical Therapy, we are committed to rehabilitating and returning you back to life’s normal activities with our effective physical therapy treatment. From diagnosis to recovery, our team of expert clinicians take the time and effort to understand the origin of your pain as well as provide the encouragement and exercises needed for long-term success. Contact us today to schedule an appointment at one of our Portland physical therapy locations.

Stretching information and images Copyright 1999-2005 VHI