Therapeutic exercise
Resisted Elbow Flexion (Bicipital Protocol)
A biceps brachii remodeling protocol with slow, controlled tempo (2 seconds up, 1 second peak contraction, 3 seconds down) — distinct from a standard gym curl in that the time under tension stimulates type I collagen reorganization in the long head tendon, within the bicipital groove. The central exercise in bicipital tendinopathy after the analgesic phase.
How to perform
- Starting position. Stand or sit in a chair with upright posture, holding a light-to-moderate dumbbell in each hand (2–5 kg initially).
- Step 2. Keep the elbows tucked against the trunk and the shoulders neutral — do not allow the elbows to drift forward of the body.
- Step 3. Flex the elbows, bringing the dumbbells toward the shoulders over 2 seconds, with gradual supination of the forearms.
- Step 4. Hold the peak contraction for 1 second at the top, actively squeezing the biceps.
- Return. Lower over 3 seconds with control, without letting the weight drop, keeping the elbows fixed against the trunk throughout the entire movement.
When not to perform
- Bicipital tendinopathy in an acute reactive phase
- Biceps tendon rupture (partial or complete)
- Medial epicondylitis in an acute phase
- Carpal tunnel syndrome with grip pain
- Recent shoulder or elbow surgery
- Cervical pain radiating and aggravated by the movement
Medical disclaimer. These exercises are presented for informational purposes only. Always consult your physician before starting any exercise program, especially in case of acute pain, recent injury, or underlying clinical condition.
Related Exercises
Shoulder Flexion with Eccentric Descent
Forward arm elevation with focus on the eccentric phase (controlled descent). Specifically loads the long head of the biceps within the bicipital groove — essential in advanced bicipital tendinopathy protocols, once initial analgesic gain has been achieved.
Prone Shoulder Extension
Strengthening of shoulder extension in a prone position, recruiting the latissimus dorsi, posterior deltoid, and long head of the triceps. Complements bicipital work in the opposite plane — essential for balancing the strength pattern around the glenohumeral joint.
Biceps Wall Stretch
Passive stretch of the biceps brachii and the long head of the bicipital tendon, with combined elbow extension and shoulder extension. Essential in chronic bicipital tendinopathy — biceps shortening is both cause and consequence.