Bicipital tendinitis is a condition caused by inflammation of the biceps tendon, resulting in pain and limited movement in the front of the shoulder. This condition usually develops due to repetitive shoulder movements or overuse and can negatively affect daily life. Treatment usually involves medications, cold applications, rest, and exercises. However, in some cases, these methods may not be sufficient. This study aims to investigate the effects of deep friction massage (DFM) when applied in addition to a standard exercise program. DFM is a massage technique that supports tissue healing, reduces pain, and improves mobility. Within the scope of the study, the effects of DFM combined with exercise on pain, functional capacity, fear of movement (kinesiophobia), and quality of life will be evaluated. The findings obtained aim to contribute to the development of more effective approaches in the treatment of biceps tendinitis.
Bicipital tendinitis is a condition characterized by inflammation of the long head of the biceps tendon, causing pain and tenderness in the front of the shoulder. It typically develops due to repetitive shoulder movements or overuse and, if left untreated, can negatively impact quality of life. Treatment for biceps tendinitis focuses on reducing inflammation and swelling, strengthening the tendon, and preventing tendon rupture. Early/initial treatments for biceps tendinitis include nonsteroidal anti-inflammatory drugs, activity modification, nonsteroidal anti-inflammatory gels or patches for pain, and cold applications for pain and swelling. If symptoms do not improve, physical therapy may be recommended. These treatments typically include stretching and strengthening exercises, massage, or ultrasound therapy. Exercises aim to help keep muscles, joints, and tendons mobile and flexible. If symptoms are severe or persistent despite initial/early treatment, the doctor may recommend a steroid injection into the affected area to reduce inflammation and pain. After the injection, patients are typically prescribed rest, ice, acetaminophen (Tylenol) for pain, and a regimen of stretching/strengthening exercises. Another important treatment method in the conservative management of tendinopathies is Deep Friction Massage (DFM). DFM is an approach that mechanically supports the remodeling of tissue and the healing process. This technique helps meet the tendon's oxygen and nutrient requirements by increasing blood flow in the treated area, while supporting the alignment of collagen fibers and facilitating the reorganization of scar tissue. The effects of deep friction massage on pain reduction and functional capacity improvement have been extensively documented in the literature. Additionally, the positive effects of this method on flexibility and range of motion from a biomechanical perspective are one of the reasons it is preferred in the management of musculoskeletal disorders. The investigators believe that the application of deep friction massage in addition to a standard exercise program in patients with bicipital tendinitis could be a useful combination therapy to support tendon healing. This approach may create a synergistic effect in tendon healing by combining the positive effects of exercise with the long-term tissue benefits of deep friction massage. There are a limited number of studies in the literature suggesting that this combination is effective; therefore, more comprehensive and controlled research is needed to guide clinical practice. Pain, functional capacity, kinesiophobia (fear of movement), and quality of life are critical in assessing the effects of biceps tendinitis on patients. Improving these parameters can accelerate patients' return to daily activities and improve their overall health. In light of this information, it is thought that the combined application of an exercise program and deep friction massage could be considered a potential treatment strategy for pain management and functional improvement in the treatment of biceps tendinitis. This study aims to evaluate the effects of deep friction massage, applied in addition to an exercise program, on pain, functional capacity, kinesiophobia, and quality of life in patients with biceps tendinitis. This will provide further insight into the efficacy of combined treatment methods and guide clinical practice.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
42
Individuals in the control and intervention groups will be included in a routine exercise program. For this exercise program; shoulder joint range of motion exercises, finger ladder, Codman and stick exercises will be given to protect functional range of motion in the early stages and to increase it in the later stages. Isometric exercises will be performed on the scapular muscles in the early stages to preserve muscle strength. In the later stages, rotator cuff, scapula stabilizers and deltoid strengthening exercises will be shown and applied, initially with low-resistance therabants for strengthening. In addition, neuromuscular control exercises and proprioceptive exercises will be included in the treatment to increase joint stabilization and coordination. Exercises will be performed for 6 weeks, 3 days a week, with 10-30 repetitions.
Individuals in the intervention group will receive a deep friction massage to the biceps tendon after the exercise program. The individual will be placed in a long sitting position with their back supported. While the patient's shoulder is next to the body and the elbow is flexed at 90 degrees, the therapist's thumb will be placed on the painful area on the extension of the biceps tendon fibers and a deep friction massage will be applied to the point where the tendonitis occurs in a transverse direction for 3-10 minutes.
Fırat Üniversitesi
Elâzığ, Merkez, Turkey (Türkiye)
Pain Assessment
The Visual Analog Scale (VAS) will be used to determine the intensity of pain and to compare the pain felt before and after treatment (baseline, 6th week and 12th week). VAS is a reliable and easily applicable test used to measure values that cannot be easily measured numerically by converting them into a numerical format. The lowest and highest definitions of the parameters to be evaluated are written on both ends of a 100 mm line. The patient is asked to mark the most appropriate value (location) between these two extreme points. When this scale is used for pain, the numbers "0" are written on one end to indicate no pain and "10" are written on the other end to indicate the most severe pain, and this is converted into a template, numbers between 0-10 are placed on the line and the patient is asked to choose the closest number.
Time frame: before-after treatment (baseline, 6th week and 12th week)
Assessment of Functional Capacity
Individuals' functional capacities will be assessed using the Shoulder, Arm, and Hand Problems Short Form (Q-DASH). Shoulder, Arm, and Hand Problems Short Form (Q-DASH): The Quick DASH questionnaire, which is the short form of the Shoulder, Arm, and Hand Problems (DASH-T) questionnaire validated and tested for reliability in Turkish by Düger et al. (2006), will be used. The 11-item questionnaire subjectively assesses the functional status of the upper extremity using a Likert scale. Patients will be asked to complete the questionnaire themselves, and the total score obtained will be converted into a total score ranging from 0 to 100 using a formula developed for the questionnaire (Gummesson et al. 2004). Values closer to 0 indicate good functional outcomes.
Time frame: before and after treatment (at baseline, 6 weeks, and 12 weeks)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.