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KortneyPA-C, Physician Assistant
Category: Health
Satisfied Customers: 54
Experience:  8+ yrs, Orthopedics, Worker's Comp, general practice
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So I injured my bicep a couple years ago lifting weights. It

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So I injured my bicep a couple years ago lifting weights. It was a while since I had lifted and I started with too heavy of a weight. So for four days my arms were stuck in one position and if it was painful. I saw a doctor afterwards and he told me i probably injured stabilizing muscles and I would heal and be fine.

It has been a years since the incident and I am working out again but I'm having an issue. My right bicep is fine like nothing ever happened. My left bicep use to be just as strong if not stronger then my right now is much weaker. The best way I can describe it is when I am doing bicep curls with my left arm it dies out very quickly. It feels as if I have no torque in my arm to crank the weight up. The bicep is full of energy and wants to lift the weight but there is just no torque or "leverage" to pull it up. Any advice would be greatly appreciated!

Ideally an MRI should be done for the exact assessment of the injury as these may involve following structures;

1) partial rupture of some of the muscle fibers
2) ligament sprain
3) tendonitis; all of which were not completely healed.

A supervised exercise regime under a physical therapist is advised who gradually increase the exercises in following steps;

1) range of motion exercises
2) exercises against resistance (with springs and elastic bands).
3) exercises under water
4) exercises with very gradually increasing weight.

This should heal these structures and gain the full strength and prevent the recurrence of injury.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.


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Customer: replied 4 years ago.

Could you give me some guidance on what part of the arm or bicep would be responsible for creating leverage or torque in a curling motion? It has been years and feel that something that could naturally be healed would've happened by now.


Apart from biceps, pectoralis major and deltoid too have role to play in the torque in curling motion. Muscles work in an integrated fashion and while some muscles contract other relax during the same movements and there are isolated muscle fibers group which are working in the individual muscles in integrated fashion. So these are very rarely and isolated muscle injury and all muscles of the arm would need strengthening.

It is privilege assisting you.
Customer: replied 4 years ago.

Ok....are there any muscles that connect from the bicep to forearm that may be involved because based on how I feel, it seems that something in between the bicep and forearm is giving out. Let me know what you think. Thanks

You are most welcome.

Apart from the rotator cuff (which act mainly on shoulder), coracobrachialis is the most important muscle with the bicep muscle in this movement.
Customer: replied 4 years ago.

It has nothing to do with the shoulder I am sure of. It is something between bicep and forearm.

Customer: replied 4 years ago.
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Hello, I would like to try to help provide some additional information for you.

From what I have read, it appears that you are feeling weakness in your biceps area when you attempt to do biceps curls in the gym, but this is on the opposite arm from when you had your injury over a year ago.

Occasionally when you have an injury on one side of your body, whether in your upper arm, lower arm, or leg, you can get overcompensation injuries on the opposite side. You were likely guarding your injured arm over the last year in an attempt to allow it to heal and this caused a lot of extra stress on your un-injured arm. Overcompensating for an injured arm can result in significant injury.

If you can imagine, when you has not been using one side of your body, whether arm or leg, you are doing everything with one arm/leg. Not only are you using the uninjured arm for extra tasks, but you are also placing extra weight on that arm because you have been unable to use the injured arm to lift, push, pull, etc.

I am inclined to believe that you likely sustained a tear in one of the ligaments or tendons in that arm, which has led to the weakness that you describe. However, it is also very likely that you sustained a neurological injury, which can result in weakness as well. Do you feel any burning sensations, tingling, numbness, and/or pins-and-needles sensations? These symptoms all describe a neurological process. If you are not experiencing any of those symptoms, I think we can basically rule out a neurological problem.

If your only symptom has been weakness when you are trying to perform weight lifting at work, you may have sustained a tear of the biceps tendon AT THE ELBOW. Not only can tears of the biceps tendon occur at the shoulder, but they can also occur at the elbow at the distal attachment of the muscle. There is a tendon that attaches at the elbow and when you describe that you feel that symptoms come from below the biceps and above the forearm, you are more than likely describing a tear of this tendon. You may also be suffering from a tear of another muscle, ligament or tendon, but with what you describe, my best guess is that you have a biceps tendon tear. Do you see a deformity of the muscle? Sometimes when there is a tear of the tendon at the elbow, you can have what they describe as a “pop-eye” deformity. You would have a big bulge in the muscle, like the one that you would expect to see on the cartoon character pop-eye, which is not normal.

Even if you do not have a deformity, you probably still have a least a partial tear of the tendon, which does require treatment to include probable surgery. In order to correct a tear of the biceps tendon, given that the biceps muscle is such a large muscle and is used for a lot of function, surgery is usually necessary. In the initial phase of treatment, however, for a partial tear, you would likely be referred for a course of physical therapy that would education in exercises that can be performed to strengthen both the muscle and the tendon. If physical therapy were not effective, then you would likely proceed with surgery.

The diagnostic study of choice to evaluate this tendon would be an MRI of the elbow. Most physicians can determine at your initial visit whether they believe you have a partial or full-thickness tear of the biceps tendon. However, for confirmation, an MRI would be obtained initially.

Depending on the severity of her condition, your doctor would advise you to restrict your activities with that arm. This is where you may get into trouble again because when you restrict your activities with that arm, the previously injured arm is now at risk for an overcompensation injury as well. You should be very careful about what activities you perform until you are able to see a doctor and have an imaging study. I would not advise further weight lifting with either arm given the potential for further injury to the previously injured arm as well as further injury to the tendon and/or further tear of the tendon if you already have a partial tear.

It is necessary for you to see a physician in this regard. No one can provide you with a definitive answer without a full examination and an imaging study. In my patients who present with a likely tear of the tendon, I immediately refer them for an x-ray and an MRI, which is likely what you will be referred for.

It is usually effective to take anti-inflammatory medications if you have any type of pain, but usually these types of injuries are largely not painful most of the time.

Do you have any additional questions for me about this? My question for you is do you have any symptoms that go down past the elbow? You describe symptoms that are between the forearm and biceps muscle; however, do any symptoms radiate down to your hand or possibly up into the neck? Sometimes when you have an injury in your neck, such as a disc bulge/protrusion, this can create compression on the nerve in your neck that goes into your arm. If you have compression of the nerve in your neck, this can cause weakness in the muscles in the arms. This may be also what you are suffering from, but I would expect you to have some type of neurological symptoms, such as the burning sensation, pins-and-needles sensation, or numbness. Do you have any additional concerns? Please do not hesitate to ask anything additional that you need to at this time and I will try to answer your additional concerns. My only goal is to make sure you are completely satisfied, so please don’t hesitate to ask follow up questions. We are not done here until you are satisfied so please don’t accept my answer or provide my rating until you are satisfied. Looking forward to hearing back, so very sorry about your troubles!!
Customer: replied 4 years ago.

I injured both arms about 5 years ago. Both healed and I started working out again. At this point, I noticed my left arm just wasn't feeling the same while my right felt as if nothing ever happened. So there was never an overcompensation on either arm. I do not have any deformity in my bicep, it looks normal. It just seems as if my bicep is giving out on me before the actual muscle is reaching failure. It as if the other muscle which creates the Torque, leverage, or cranking power(whatever creates the power to curl upwards) is giving out before the bicep can get a full work out. Does this sound like anything you've seen in the past or does this change your observation. I went to a sports medicine doctor when this first happened and he did some range of motion exercises and what not and said it was probably just some minor stabilizer muscles that tore and they would heal. Maybe I was misdiagnosed. Hope this helps clarify my situation. Also just to be more clear, at the beginning of my workout both arms are equally as strong, but the left one rapidly decreases while the right arms keeps charging.




When you describe early fatigue of a muscle, that makes me think of a neurological condition, and/or a tear. In my experience, with patients that I have seen, when there is a tear, there are two main symptoms. Usually, they can recall a specific event or time that the injury occurred when they felt a pop or click in the arm. One of the symptoms is inability to perform tasks that were usually not a problem to perform, a feeling of instability in the arm, and early fatigue. The most common symptom of a muscle tear is a sudden and sharp pain in the upper arm, This is accompanied by cramping (or what you describe as fatigue) of the arm or "early failure." The cramping or fatigue can even occur after usage that is otherwise tolerable in a healthy individual. Sometimes, when the muscle detaches itself from the bones, you can hear an audible "pop!" There is also muscle pain and tenderness at the shoulders and elbows. Most of the time in the presence of a biceps tendon tear, there is usually difficulty in turning the palm up or down. Due to the tearing of the biceps muscle, do you have this symptom? a bulge or a bruise may appear on the upper arm, but, in your case is not present. I would also expect that you may have a tear in your forearm muscles too. The forearms also help with biceps curls. If there is a muscle torn in your forearm, you may have been advised that it will heal over time by your doctor, as you stated, but since you seem to still be having significant difficulty with it, I would get a second opinion. It is always necessary to observe the injury at first, take anti-inflammatories, and do exercises and modify your activities. If there is still significant functional difficulty, an imaging study is NECESSARY!

We could keep going back and forth about the many possible muscles that could be torn, but my feeling is that you likely have torn one or more than one of your muscle tendons or attachments. This is actually pretty common in weight lifters. You describe an injury 5 years ago and you improved and started lifting weights again, then you developed this new symptom of early fatigue of your left biceps. It is quite likely that you had some fraying of the muscles from your prior injury and the already weakened muscle tore when you began to increase the weight that you are lifting. You wouldn't believe how very common it is in men that weight lift (and women too).

I don't have a definitive answer for you, I know that you are looking for an answer on what muscle may be actually injured, but the only way to determine this is with an imaging study. Given that you are weight lifting and placing extreme stress on your arms very frequently, I believe it is absolutely essential that you have an imaging study to see what is going on before you pursue additional weights, etc. I would see another physician, an orthopedic surgeon would be best. An orthopedic surgeon (whom I happen to work with) should send you out for an MRI right away so that treatment can be discussed. This is what I recommend and I recommend that you do it soon before you really do some damage with your weight lifting.
Customer: replied 4 years ago.

Can you give me a referral to with a prescription for an MRI or is that something I need to go do on my own.

Yes, unfortunately, I cannot write a prescription for treatment for you if I do not see you personally. In the US, this is considered to be illegal in most cases. A full physical examination is necessary anyways in order for your insurance to cover the service. If you do not have insurance, there are free clinics available or lower cost clinics that you can search for on the internet in your area. You should go to an orthopedic surgeon for the referral for an MRI study.
KortneyPA-C, Physician Assistant
Category: Health
Satisfied Customers: 54
Experience: 8+ yrs, Orthopedics, Worker's Comp, general practice
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