Treatment for Bicep Strain
The treatment for a bicep strain should include relative rest of the affected area, application of cold therapy (ice) for 20-30 minutes at a time, and avoidance of activities that cause pain. 1
Initial Management
- A person with a painful extremity injury that limits use should avoid activities that cause pain and seek medical attention 1
- Apply cold therapy (ice and water surrounded by a damp cloth) to the strained bicep for pain and swelling relief, limiting application to 20-30 minutes per session to avoid cold injury 1
- Cold application decreases pain and swelling in muscle strains but has not been demonstrated to improve function or time to recovery 1
- The greatest tissue cooling is achieved using a bag filled with ice and water surrounded by a damp cloth 1
Ongoing Treatment
- Most patients with muscle strains (approximately 80%) fully recover within three to six months with appropriate conservative treatment 1
- Eccentric strengthening exercises should be started as soon as pain allows to prevent muscle atrophy and promote healing 1
- Oral or topical NSAIDs can provide effective short-term pain relief in the acute phase, though they do not affect long-term outcomes 1
- Topical NSAIDs may be preferable due to fewer systemic side effects 1
Compression Therapy
- A compression wrap may be applied to promote comfort after the injury 1
- Ensure the compression wrap is not too tight to avoid compromising circulation 1
- Evidence suggests compression wraps do not reduce swelling or pain during the recovery timeframe, nor improve function, range of motion, or time to recovery 1
Rehabilitation Phase
- Gradual return to activity within pain limits is essential to optimize muscle regeneration and recovery of flexibility and strength 2
- Progressive strengthening exercises should be initiated as pain and swelling subside 3
- Avoid excessive fatigue and perform adequate warm-up before returning to intense exercise to prevent re-injury 3
When to Consider Advanced Treatment
- If pain persists despite 3-6 months of well-managed conservative treatment, further evaluation may be warranted 1
- For severe bicep tendon damage or complete tears, surgical consultation may be needed 4
- MRI or ultrasound imaging may be helpful if the diagnosis remains unclear or if a complete tear is suspected 4, 5
Common Pitfalls to Avoid
- Avoid complete immobilization for extended periods as this can lead to muscle atrophy and deconditioning 1
- Do not place ice directly on the skin to prevent cold injury 1
- Avoid returning to full activity too quickly, which can lead to re-injury 2
- Don't ignore persistent pain, as it may indicate a more severe injury such as a partial or complete bicep tendon tear 6