TEN-YEAR FOLLOW-UP OF PRELIMINARY BICEPS BRACHIAL MUSCLE CONTRACTION IN THE REHABILITATION AND PROPHYLAXIS OF RECURRENT SHOULDER PAIN DUE TO TENDON DEGENERATION
Authors:   Department of Physical Medicine and Rehabilitation, Medical University-Sofia, Bulgaria., Aleksiev A. , Matsanova-Simova V. ,   Department of Physical Medicine and Rehabilitation, Medical University-Sofia, Bulgaria., Nikolova-Shopova S. ,   Department of Physical Medicine and Rehabilitation, Medical University-Sofia, Bulgaria., Dimitrova V. ,   Department of Physical Medicine and Rehabilitation, Medical University-Sofia, Bulgaria.
Published: April 2021

Introduction:- One of the overlooked facilitating factors of recurrent shoulder pain due to tendon degeneration is the periarticular muscle latency (M1, M2, and M3). It leads to a lack of muscle protection against the external loads on the shoulder during the initiation of every shoulder movement. This creates multiple repetitive micro-traumas, gradually accumulating to tendon degeneration. The only way to overtake the periarticular muscle latency and its consequences is the preliminary biceps brachial muscle contraction. Aim:- To study the effect of the preliminary biceps brachial muscle contraction on the short-term rehabilitation and the long-term prophylaxis of recurrent shoulder pain due to tendon degeneration. Material and Methods:- For 10 years were followed 44 outpatients (age 50.1 Â± 14.8 years) with recurrent shoulder pain due to tendon degeneration. They were randomized into two groups â€“ standard (n=22) and maneuver (n=22). Both groups received prophylactic recommendations and were treated for two weeks with exercise, interferential current, and laser. The maneuver group received an additional recommendation to perform preliminary biceps brachial muscle contraction before every movement of the shoulder during the daily activities. Pain intensity, shoulder mobility, periarticular muscle strength, number of recurrences, number of rehabilitation courses, and success rate of the maneuver were followed-up for two weeks and ten consecutive years. For the statistical analysis, ANOVA with Bonferronis tests and Pearsons correlation with regression tests were used. Results:- The pain decreased significantly after the first day in the maneuver group (P<0.05), and after the fifth day in the standard group (P<0.05). All results improved significantly after two weeks (P<0.05) and after one year (P<0.05) in both groups. The maneuver group showed superior results versus the standard group after two weeks (P<0.05) and after 10 consecutive years (P<0.05). With increasing the maneuver success rate, the short-term treatment effect and the long-term prophylactic effect increased in the maneuver group (P<0.05). There were no dropouts, side effects, or complications. Conclusion:- The preliminary biceps muscle contraction is appropriate an important additional recommendation in short-term treatment and long-term prophylaxis of recurrent shoulder pain due to tendon degeneration. It is simple, quick, effective, and without side effects or complications. It requires no allocation of space, time, or resources. This maneuver protects the shoulder before the initial external forces, avoiding the repetitive micro-traumas during the muscle latency, which is otherwise inevitable in daily activities. Another protecting factor is the increased muscle strength and co-contraction of all periarticular muscles, as a result of this bracing maneuver, leading to lesser pain with higher shoulder stability and mobility.