I've got a patient at the moment who has a bicep tendon opathy. Now I'm not talking long-hander bicep at the top, I'm talking down here in that insertion part down at the radius. Now we're giving him three exercises to do because this one is not a normal tendon tear, it's just a tendon opathy from overload. So we've got to get up, has base strength from the tendon, so then you can return to doing normal bicep work and pulling work. So the three things I gave him was an isometric one, a closed chain bicep kill, and then a band bicep kill with a bias to help him with his supination partner, explain why. Now the first thing I got him doing was working on how do I get him doing isometric work, like say with a dumbbell, how do I get him doing, say holding isometric work without having to lift the dumbbell up, because even just getting it up there would be painful. So what we've got to try and do is not use a dumbbell, best thing to do is use something like a bar like this that's heavy enough, like a 20 kilo bar, and get under it this way. So what you're doing is you go into a 90 degree position at the elbow and then work on just trying to lift that bar up. Okay, now usually you won't be heavy enough to hold a 20 kilo bar like what that's doing, if you see, is turning on that 10 and 100%. Okay, so I'm doing as hard as I can lifting up below pain. Okay, so these isometric loads was below pain for about 30 seconds at a time. Just him trying to get in and out, if you want to put more load through it, put him in the middle of the bar, grip the bar as well, trying into that nice 90 degree position, so you don't need too far forward or too far back like that. So writing all this here and then lifting that bar, so he's switching on and activating that 10 and firing it up. So this is a really good prep exercise for him. The beauty about this is he can go right up as hard as he possibly can, because you can put a lot of load through a tendon when it's got a tendon up there. If you don't contract the tendon through an elbow joint, range of movement. So you're doing contracts on the tendon, statically, hence the word isometric, right? So because I'm not shifting any sort of movement of the joint, I'm not loading it through range. It's pretty safe to add on more load. So this gives you a lot of chance and opportunity to do high load with no pain and damage, whereas if I put my rope with the same elbow through a bicep curl, it would cause pain. So very awesome way of starting a strength thing work. When you've got a tendon up there, it's the start doing isometric holds up to max more, almost failure below pain. And do about three or four sets of that. I've trying to get in there for 30 seconds. So that's a really, really nice one. Now, the other thing we were trying to get him doing was doing a bicep curl, but, and what we call like a closed chain position, because we're sort of following some of the nice eccentric type positions that we do for tendons, okay, eccentric work. So for this one, what we're gonna try and do is do a curl using this bar again, okay, and getting it up into this position here. So it's a little bit higher, and then always coming around from the back, okay, if you come around from this, we're gonna flip up and go that way. So we go around from the back. Now, with this one, what you've got to try and do is not turn it into some sort of row where you're using your lats on the back of your shoulder. We've gotta be trying to be strict about the bicep and the elbow doing the work. Of course, there's gonna be a little bit of shoulder, but we've gotta try and bicep to the bicep to doing most load down at the elbow, because remember, that's where that bicep 10 and problem was. Me, it's not a long-haired bicep, it was down here. So from this position, we try and get pretty close to the bar, and do basically a bicep curl, but you're doing it with the body moving, right? And the hand not, because the judicial bicep curl is this way, right? So this is more like a chin-up or a supine row, that sort of thing, where the body moves, and the hand doesn't. Of course, you can't put as much load through the bicep and the 10 as you could with weights and doing lap pull downs and things like that, but hey, we're doing a rehab. We don't need to put a massive amount of load through this just yet, because it's got a 10 and off fee. We wanna put a moderate amount of load, which is nice and safe and controlled, and doing this sort of thing, you can feel it. Now you can see I'm not doing a massive amount of row with the bullwhip that way. I'm not doing a big sort of row where I'm coming in and pulling back and doing all this sort of long lever stuff where I need my lap. We're doing sort of short lever work into that bicep, working through mostly the mid to upper range. Now, of course, it gets easier when I get up here, but that's the nature of it. So that was a really nice one from to do, while he's waiting for that 10 and to get better and then get into bicep curls. But what I can give him is a bicep curl with a band because with a band, the band is greater. So, meaning when you like with all bands, when you contract and get the band longer, and the muscle gets shorter, that's in a stronger position, the band's longer, the load is all relative. With a bicep curl with a dumbbell, this is where people struggle when they've got an injured bicep tin and they're trying to just use dumbbells. When they do this, at here where the bicep in is the weakest, the load's really heavy. It doesn't really change all the way up. So you've got to be strong at the bottom for a start, all you have to have the weight really light so that both are not going to work. So what I suggest you do is get something like your trusty, thoroughbanned. Now, depending on how strong you are, how much damage you've got, how much injury you've got, would determine how big the band is. You're gonna have to play around with that. But with this one, what you're doing, as you're trying to have that basically band not going that way, okay? We want the band, I feel like, going that way, okay? Because what the bands trying to do is pull me inwards. So if you look at that angle, if I'm out here, that band is trying to pull me into pronation. Now, what does that bicep tendon do when it hooks into the radius? It does supination. All right? So when you're doing bicep calls and you're coming up, then you realize that you come from here and you supinate up, part of that is the bicep tendon doing that because it's connected to the radius. So it's gonna supinate the arm. So we use that to go, okay, when you come up like this, I want a pronation drag. So I'm forced to supinate the whole way. Now you can get clever. You can stay in supination. So that band is off on an angle, down on an angle. So I'm forcing my tendon on at this point to work not just for bicep curls and elbow flexion, but I'm also working especially down here. That's working on your supination part because it wants to flick me into pronation. All right, so from here, I'm supinated and then supinated the whole way up into flexion and then slow on the way down. And you can really feel that. Now the good thing about this is this part here, my tendon is longer, it is weaker. All right, the band is less. When my tendon's shorter, the band is harder. It's all relative, okay? So as you go down, you go, oh, that's hard, that's hard, but it gets relatively easier as the tendon gets longer. So it sort of feels like the same all the way through. That's when you can really work out what band strength is appropriate for your arm. All right, when you get better at that, you can then go from pronation and then twist through the movement, okay? And then down. So what you're effectively doing is giving that from that pronation position, you drag into supination as you flex and then down. And right there, it takes a little bit of coordination with that one, but again, this is gonna work on some functionality of that tendon. Not just how strong and how big you can get it. The function of what you're doing through that movement, which will help you with all sorts of pulling and bicep curl work. And then they progress back to normal dumbbells, normal rows, normal weights, normal chinups, that's something. But this is a really nice interim step when you've got that sort of subacute to a Q10 and opathy where it's not a tear, it's a weakening of the tendon and you've got to build it back up to normal. This is a great start. See you next time.