Holshouser Cameron, Jayaseelan Dhinu J
Total Motion Physical Therapy, Blacksburg, VA 24060, USA.
Department of Health Human Function and Rehabilitation Sciences, The George Washington University, Washington, DC 20006, USA.
J Funct Morphol Kinesiol. 2020 Jul 29;5(3):56. doi: 10.3390/jfmk5030056.
Distal biceps brachii tendinopathy is an uncommon diagnosis. Various exercise prescriptions have demonstrated efficacy in the management of tendinopathy, although studies frequently focus on the effects of a specific type of muscular contraction (i.e., concentric, isometric, or eccentric). Currently, there is limited research guiding the conservative management of distal biceps tendinopathy, particularly with overhead athletes, and even less evidence reporting a multifaceted exercise prescription for individuals with tendinopathy. The purpose of this case report is to describe the integration of various modes of therapeutic exercise into a rehabilitation program for an overhead athlete with suspected distal biceps brachii tendinopathy.
A 19-year-old male collegiate baseball pitcher presented to an outpatient physical therapy clinic via direct access for left antecubital pain, which began 6 weeks prior to the evaluation while pitching during try-outs. Following physical examination, distal biceps tendinopathy was the likely clinical diagnosis. Interventions focused on early eccentric exercise eventually progressing to concentric and plyometric activity for return to sport.
The patient was seen five times over the course of 4 weeks. He had significant improvements of pain, patient-reported functional outcomes, global rating of change, strength, tenderness, and provocation testing. The patient was able to return to an off-season pitching program.
An impairment-based and task-specific exercise prescription was effective for this patient with distal biceps tendinopathy. Understanding the biomechanical demands of an individual's functional limitation, in this case baseball pitching, may assist the decision-making process and optimize outcomes. Additional research into the most effective exercise prescriptions for individuals with uncommon tendinopathies is warranted.
肱二头肌远端肌腱病是一种不常见的诊断。各种运动处方已证明对肌腱病的治疗有效，尽管研究通常集中在特定类型肌肉收缩（即向心、等长或离心）的效果上。目前，指导肱二头肌远端肌腱病保守治疗的研究有限，尤其是对于从事过头运动的运动员，而且报告针对肌腱病患者的多方面运动处方的证据更少。本病例报告的目的是描述将各种治疗性运动模式整合到一名疑似肱二头肌远端肌腱病的过头运动运动员的康复计划中。
一名19岁的大学棒球投手因左肘前疼痛通过直接就诊来到门诊物理治疗诊所，疼痛始于评估前6周的选拔试投期间。体格检查后，肱二头肌远端肌腱病是可能的临床诊断。干预措施侧重于早期离心运动，最终进展为向心和增强式活动以恢复运动。
患者在4周内接受了5次治疗。他在疼痛、患者报告的功能结果、整体变化评分、力量、压痛和激发试验方面有显著改善。患者能够恢复到非赛季投球计划。
基于损伤和特定任务的运动处方对该肱二头肌远端肌腱病患者有效。了解个体功能受限（在本病例中为棒球投球）的生物力学需求可能有助于决策过程并优化结果。有必要对不常见肌腱病患者最有效的运动处方进行更多研究。
