Brachialis tendonitis: Symptoms, Treatment, Exercise

Brachialis Tendonitis is a condition in which inflammation of Brachialis muscle and tendon causes pain to the affected arm with swelling.

The brachialis muscle is located under the biceps brachii in the arm. It works mainly as a forearm flexion movement, it is considered one of the strongest elbow flexors.

It is seen mostly in climbers where initially mild pain in the front of your elbow that increases after a long week of training and climbing-related activity. If you are untreated, it may gradually develop swelling in your elbow.

It is also called “Climber’s elbow”.

Causes of Brachialis Tendonitis :

It’s often difficult to exact the cause of the condition. It can be caused by an overuse sports injury, after elbow surgery, accidental trauma, vaccinations, and even sickness.

It mostly occurs during a forceful contraction or a forceful hyperextension during climbing. Complete tears are also associated mainly with elbow dislocation.

It may also muscle strain from the sudden increase in the training session, overuse or repetitive elbow bending or forced, excessive elbow straightening (hyper-extension).

Sports that are a more common cause of brachialis tendonitis mainly those that require lifting over the head or climbers. A few of them are weightlifting, gymnastics, rock climbing, bodybuilding, bowling, and sports like football, where a ball is thrown. Rock climbing and constant muscle strain on using his arms to pull himself up have put a strain on his brachial tendons.

Symptoms of Brachialis Tendonitis :

The most common symptoms are Elbow pain, spasm with weakness, and reduced movement in the affected elbow and upper arm. The pain can be sudden or gradual, and

will usually continue until the activity causing the pain has stopped.

The most common symptoms are:

• Deep elbow pain Piercing, stabbing pain at the front side of the Elbow.
• Inflammation in or around the elbow with a muscle spasm
• Reduced Elbow movement- to straighten or bend the arm
• Severe pain when straightening the elbow all the way
• Increased pain with activity
• Swelling around the elbow or above the elbow
• A popping sound in the tendon or elbow during movement

Treatment of Brachialis Tendonitis:

The most common treatment in the Acute phase is the use of the RICE Principle in which Rest, use of Ice pack with for compression you can use crepe-bandage with Elevation.

• To Relieve Pain, inflammation, and Muscle spasm, your doctors may prescribe NSAIDs such as Aceclofenac, Diclofenac.
• Pain-relieving Ointment/Gel.
• Use of Hot Pack/Cold Pack.
• Rest
• Dep tissue frictions / Massage

Physiotherapy Treatment in Brachialis Tendonitis:

The aims of treatment are mainly pain-relieving Electrotherapy modalities such as Ultrasound Therapy, TENS, Interferential Therapy(IFT) with Exercise to strengthen weak Elbow muscles, and Range of motion exercise.

Gradual Stretching exercise of tight elbow muscles to improve flexibility is also beneficial.

Strengthening exercise of Brachialis muscles :

Gradual strengthening exercises to build your muscles more powerful and you can start sports or climbing activity again after you can strengthen your muscles.

You can start Exercise progression from initially isometrics only, gradually you can start eccentric and concentric strengthening exercise,(exercise must be pain-free), progress from isometrics initially to a full range of movement around the elbow is recommended.

Due to pain and inflammation, Muscles become tight and lose their elasticity property if regular exercise is not done. Regular stretching exercise helps to maintain the mobility of muscles and elbow joints.

Wrist and elbow Flexor Stretching exercise (Pain-free gradual stretch):

In sitting or standing position with elbow and wrist are straight fully, with your palm up. Gradually bend your wrist so that your fingers are pointing towards the ground. With the help of your other hand, apply pressure onto the wrist to further bend your wrist. You should feel a gentle stretch in your forearm. (Stretch must be pain-free)

Seated Brachialis Stretch:

• Sit down on the floor. Straighten both arms, and plant your hands on the floor behind you, slightly wider than your hips.
• Turn your hands so your fingers point straight back.
• Scoot your hips slowly forward, keeping your weight evenly distributed, until you feel mild tension in your biceps and brachialis.
• You might feel a stretch across your chest, too.
• Hold the stretch for 15 to 30 seconds, breathing normally, then scoot your hips back toward your hands to release the stretch.
• Repeat a total of three to five times.

Supinated dumbbell bicep curls exercise:

You can start in shoulder-width apart standing position with an upright posture, scapulas retracted (shoulder blades squeezed together), elbows at your side, and your palms facing up.

Do a Dumells curl exercise in a full range of motion and a controlled movement on the way down to the first position.
With a supinated grip, In this exercise muscle works mainly elbow flexor mainly are brachioradialis, brachialis, and biceps brachii.

Preventive measures :

Following preventive measure is helpful to reduce the risk of Re-injury.

• A regular warm-up exercise is the best prevention method
• Confirm proper recovery time before starting sports or climbing days
• All-round strengthening and stretching exercise of Upper Back, shoulder Girdle muscles with biceps and brachialis can maintain an overall good strength can reduce possibilities of muscle strain.
• Maintain your fitness level- improve stamina, add a protein-rich diet and reduce fat in your meal.