Biceps Brachii

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The Biceps Brachii is a muscle of the arm.

Anatomical Attachments:

• Origin: The short head attaches to the tip of the coracoid process of the scapula. The long head attaches to the supraglenoid tuberosity of the scapula.
• Insertion: Attaches to the radial tuberosity, by the lacertus fibrosus to origins of the forearm flexors.

Action: Flexes and supinates the forearm, and when the forearm is stabilized or fixed, it flexes the arm.

Synergist: Coracobrachialis, Brachialis, Brachioradialis, Supinator, anterior division of the Deltoid, Supraspinatus, Pectoralis major.

Antagonist: Triceps brachii, Anconeus.

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Nerve Supply: Musculocutaneous Nerve (C5, C6).

Vascular supply: Muscular branches of the brachial artery.

• Primary: The primary referral pattern is experienced from the anterior division of the deltoid down the arm, over the course of the Biceps, with a fainter referral being experienced in the fold of the arm. Occasionally the pain is experienced in the suprascapular region, omitting the shoulder. When the pain referral is localized to the anterior division of the Deltoid, it is easily confused with either, trigger points in the Deltoid, Subdeltoid bursitis, or Bicipital tendinitis.
• Satellite or associated triggers: Brachialis, Supinator, Triceps brachii, anterior Deltoid, Supraspinatus, upper Trapezius, Coracobrachialis.

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Trigger Point Signs and Symptoms: Trigger points in the Biceps brachii are palpable; otherwise the symptomatology is essentially the same as with bicipital tendinitis. Point tenderness is experienced at the bicipital groove of the humerus. There is pain associated with forearm flexion and supination. Abduction of the arm is painful with the individual having the expressed inability to elevate the arm above shoulder level. With Bicipital tendinitis, suprascapular pain would not be experienced. With both conditions, there is an expressed inability to lie on the affected side and a history of, repetitive forearm flexion, mechanical overload, or engaging in a sports activity such as baseball or tennis.

Trigger Point Activating and Perpetuating Factors: Carrying a heavy suitcase with the elbow bent, shoveling dirt or gravel, forearm curls or chin ups with palm supinated, reaching behind to break a fall.

Differential Diagnosis: Bicipital tendinitis, Subdeltoid bursitis, (Segmental, Subluxation, Somatic dysfunction) C5 or C6 radiculopathy, Shoulder pointer, Sprain/Strain injury or muscle tear, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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