Dry Needling and Exercise Versus Traditional Physical Therapy for Biceps Tendinitis

Summary

The aim of the research is to determine if participants who receive physical therapy (physiotherapy) including soft tissue mobilization, dry needling, Heavy slow load (eccentric-concentric) exercise (with hand weights specific to the biceps muscle) and a comprehensive rotator cuff and scapular stabilization program achieve greater reductions in pain and disability in the short (3-4 weeks) and long term (6 months) compared to those who receive soft tissue mobilization and a comprehensive rotator cuff and scapular stabilization program. Both treatment approaches are within the standard of care for physical therapists, the aim being to determine the most effective treatment approach. Study participants will be recruited form clinicians and flyers within the university/hospital organization where the study is taking place. Participants will be asked to attend 6 physical therapy visits and complete 6 surveys about their pain and disability.

Conditions

• Bicep Tendinitis
• Biceps; Tenosynovitis
• Bicipital Tendinitis, Left Shoulder
• Bicipital Tendinitis, Right Shoulder
• Bicipital Tendinitis, Unspecified Shoulder
• Biceps Tendon Disorder

Interventions

OTHER

Dry Needling

Dry needling directly to the long head of the biceps tendon. The DN will be performed with disposable stainless-steel needles (.3 X 40mm; Seirin; Weymouth, MA) inserted into the skin over the most painful and/or thickened areas of the tendon, confirmed with palpation. Prior to insertion of the needle the overlying skin will be cleaned with alcohol. The needle will be inserted into the tendon. The technique will be a fast-in and fast-out technique described by Chiavaras et al.26 for 20-30 repetitions per session in up to 3 areas. An eccentric-concentric exercise program of the biceps muscle/tendon will follow each DN session and will be performed daily for the course of treatment and will be performed as described by McDevitt et al.

OTHER

Heavy Slow Load Exercise

Eccentric exercise protocols have been found to be an effective treatment for tendinopathies of the upper and lower extremities and recent evidence supports heavy slow resistance training (including the addition of a concentric phase) as having better outcomes over eccentric exercise alone. Patients will use 1-5 pound weights to perform slow and controlled concentric and eccentric exercise to biceps muscle.

OTHER

Rotator cuff and scapular stabilization exercise program

Both groups will be treated with a stretching and strengthening program. The rotator cuff and scapular stabilization strengthening and flexibility program used in this study has 3 phases and patients progress in phases based on their ability to perform a number of exercises using theraband or body weight resistance.

OTHER

Soft tissue mobilization

Both groups will receive soft tissue mobilization to the anterior shoulder.

Sponsors & Collaborators

• University of Newcastle, Australia

  collaborator OTHER

• University of Colorado, Denver

  lead OTHER

Principal Investigators

• Amy W McDevitt, DPT · University of Colorado, Denver

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

64 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-09-30

Primary Completion

2025-12-31

Completion

2025-12-31

Countries

• United States

Study Locations