Norwegian 4×4

You may have heard of this but weren’t sure what it means. Here’s our summary.

The Norwegian 4×4 is a method of Cardio Training where you perform 4 reps of 4 minutes of cardio, with a 3-4 minute rest in between. For example, you might run for 4 minutes, then rest for 3, then run for 4 again, rest 3, run 4, rest 3 and finish with your 4th 4 minute run. Or you might do this on the exercise bike, or the elliptical, the rower, or if you’re a complete maniac, the assault bike.

It doesn’t really matter which form of cardio you choose, but here’s the catch, you need to do it at a fairly high intensity. The kind of intensity where at the end of the 4 minutes you’re pooped and very happy to be able to have a few minutes rest.

Why has it become so popular? Because it has been shown to be INCREDIBLY effective. And the results of doing this for just a few months can last for YEARS!

One study showed that doing this protocol 3 times a week for 6 months yielded benefits that lasted 5 years later!

Some quotes:

Short-Term and Cumulative Effects

  • VO2 Max Surge: Rapidly increases maximum oxygen uptake by 7% to 13% within 8 weeks of consistent training (2–3 times a week). [1, 2]
  • Cardiovascular Remodeling: Enhances stroke volume (blood pumped per heartbeat), strengthens the heart muscle, lowers resting heart rate, and reduces blood pressure. [1, 2]
  • Brain Health: Stimulates superior structural and functional improvements in brain regions like the hippocampus compared to steady-state zone 2 cardio.

Long-Term Effects (Over 5 Years)

  • Retained Cognitive Protection: Research on older adults completing a 6-month high-intensity interval training 4×4 intervention showed that the structural brain benefits and enhanced hippocampal function were largely preserved when tested 5 years later, even if participants dropped back to lower baseline activity levels. [1, 2]
  • Cardiovascular Resilience: A sustained multi-year habit or baseline fitness built from the protocol contributes to long-term reversal of vascular and cardiac aging, keeping the heart structurally flexible. [1]
  • Metabolic Memory: Sustained mitochondrial and enzymatic efficiency helps buffer against rapid age-related fitness decline, though cellular adaptations do partially regress if high-intensity work is completely abandoned for the entire 5-year duration. [1]
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Do Knee Arthroscopies Actually “Work”?

And more importantly, could they actually make your knee worse?

A new article was just published on Medscape that looked at the effectiveness of knee Arthroscopy surgery. Specifically, they were looking at people who had degeneration or small tears in the meniscus (cartilage). Surgery is commonly prescribed for people with knee pain who have this finding show up on an MRI.

The article reports 10-year follow-up results from the FIDELITY study, which tested whether arthroscopic partial meniscectomy, a common knee surgery, helps people with a degenerative meniscal tear. In this procedure, surgeons remove damaged pieces of cartilage from the knee. The researchers wanted to know whether this surgery actually improves pain and function over the long term, or whether it offers no real advantage. Medscape

To study this fairly, the trial used a sham surgery comparison. That means some patients had the real surgery, while others went through a fake version in which the surgeon copied the motions of surgery but did not actually remove any meniscus tissue. This matters because it helps separate the true medical effect of the operation from the placebo effect, where people may feel better simply because they believe they were treated. Medscape

The study included 146 patients between ages 35 and 65. Earlier results after 1 year had already shown no meaningful difference between the real-surgery group and the sham-surgery group in knee function, quality of life, or pain after exercise. The new 10-year follow-up showed that this lack of benefit continued over time. According to the article, there were no significant differences in any of the three main outcomes measured between the two groups after a decade. Medscape

One of the most important findings was that the surgery may not just be unhelpful, but possibly harmful. Among the 133 patients who were assessed at the 10-year mark, 22% of those who had the real surgery developed clinical knee osteoarthritis, compared with 19% in the sham-surgery group. The article also says that radiographic progression of osteoarthritis was higher in the surgery group, at 81%, compared with 70% in the sham group. Medscape

The lead researcher, Teppo Jarvinen, said the earlier 5-year results had already suggested no real benefit, but the signs of harm became more striking by 10 years. In the article, he describes how the surgery group seemed to do similarly at first, but then their outcomes worsened later on. This is important because it suggests the surgery might speed up wear and tear in the knee instead of protecting it. Medscape

Another expert quoted in the article, Rachelle Buchbinder, said these results fit with other evidence showing that arthroscopy does not help this type of knee problem. She explained that doctors once thought the surgery worked like “cleaning out” the joint, but the newer evidence suggests the opposite may be true. Instead of fixing the problem, removing tissue may disturb the knee and make degeneration happen faster. Medscape

The bigger message of the study is that more treatment is not always better treatment. Even though surgery can seem like a stronger or more direct fix, this research suggests that for degenerative meniscal tears, it does not improve long-term results compared with a placebo procedure. Because this was a placebo-controlled trial, the evidence is especially strong: it reduces the chance that the results were caused by patient expectations alone. Medscape

The easiest takeaway is this: the study found that knee arthroscopy did not help patients feel or function better in the long run, and it may have increased the risk of arthritis getting worse. That makes the research important for both doctors and patients, because it challenges a surgery that has been widely used for years. In simple terms, the study says that a common operation for age-related meniscus damage may not only fail to help, but could actually leave the knee worse off over time. Medscape

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Experimental Arthritis Injection Looks Promising!

Ok I know this is super early stage, and it’s only been tested in animals so we can’t read too much into it.

Buuuuuttttttt…..

the early signs are very promising! And at the very least they provide a pathway to future research. To read the original article, click here.

To date, the way we try to help people with arthritis is either medications from doctors, or treatment from Osteopaths aimed at improving joint mobility and exercises to increase joint stability so that people can maintain normal function. But none of these can actually reverse the effects of arthritis, eg regrow worn down cartilage.

This new article reports on an experimental osteoarthritis treatment that aims to do something much more ambitious than ordinary pain relief: actually help damaged joints repair themselves. The researchers describe two new therapies, with the headline result being that a single injection restored arthritic joints to a healthy state within weeks in animal studies. That is why the story is getting attention – it suggests a possible shift from managing symptoms to trying to reverse the disease itself. ScienceDaily

The first treatment uses an FDA-approved drug delivered in a new way. Instead of a one-off dose that quickly fades, the team built a particle-based delivery system that can be injected into a joint and then release the drug gradually over several months. The idea is to create a longer-lasting healing effect inside the joint, rather than offering only short-term symptom control. ScienceDaily

The second treatment is designed for more serious cartilage or bone damage. It uses engineered proteins placed into the damaged area during an arthroscopic procedure, where the material hardens and helps attract the body’s own progenitor cells to repair the defect. In the report, the researchers say this approach led to full regeneration and repair of cartilage and bone defects in the animal work they described. ScienceDaily

What makes the findings especially notable is that the therapies were not only promising in animals, but also showed regenerative effects in human cells taken from patients undergoing joint replacement. Even so, this is still very early-stage research. The study results highlighted here have not yet translated into proven treatment for everyday patients, and the team says it plans to publish the animal data in a peer-reviewed journal later this year, with human clinical trials possibly beginning in about 18 months if progress continues. ScienceDaily

For the average person, the most important takeaway is hope, not immediate availability. If you have osteoarthritis, this article does not mean there is a new injection you can book now that will reverse your condition. It does mean researchers are actively working on treatments that may one day reduce the gap between painkillers on one side and major joint replacement surgery on the other. ScienceDaily

The practical action steps right now are more grounded: stay physically active within your limits, keep a healthy body weight if possible, and seek early assessment for persistent joint pain rather than waiting until movement becomes severely limited. Structured exercise, strength work, and physical therapy remain the main evidence-based ways many people can reduce pain and maintain function while research like this is still developing. If symptoms are worsening, it is worth asking a clinician about the full range of current options, including rehabilitation, medication, injections already in use, and whether imaging or specialist review is appropriate.

The article is exciting, but it should be read with one important caution: animal success is not the same as proven human benefit. Many treatments that look dramatic in early studies do not end up working as well, as safely, or as consistently in real patients. The sensible response is to treat this as a promising glimpse of where osteoarthritis care may be heading – and in the meantime focus on the current basics that are actually available: movement, strength, weight management, symptom monitoring, and early medical advice when pain starts interfering with daily life.

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What is Brain Stretching? And can it help prevent Dementia?

A new article from ScienceAlert explains that keeping your brain active and challenged—what researchers call “brain stretching”—may help protect against dementia as we age. Dementia, which includes Alzheimer’s disease, causes memory loss and thinking problems, and scientists are still searching for effective ways to prevent it. This new research highlights the power of mental activity and lifelong learning in keeping the brain healthy.

The study, led by researchers in the United Kingdom, followed thousands of older adults for several years. They found that people who regularly engaged their minds with new and complex tasks—such as learning a language, playing an instrument, or tackling challenging hobbies—had a lower risk of developing dementia later in life. The idea is similar to how exercising your body strengthens muscles: exercising your brain strengthens neural connections.

Researchers explained that when we challenge ourselves mentally, the brain builds new pathways and becomes more resilient to damage over time. This process is known as “cognitive reserve,” meaning the brain develops backup systems that help it function even if parts of it start to deteriorate. People who keep learning and problem-solving may be better able to cope with the physical changes that come with aging.

Interestingly, the benefits weren’t limited to academic activities. The protective effect appeared for people who did creative or social activities, such as painting, volunteering, or engaging in deep conversations. What mattered most was that the activity was mentally stimulating—something that forced the person to think in new ways or learn new information.

The study also showed that simply keeping busy isn’t enough. Routine or repetitive tasks—like watching TV every day or doing the same crossword puzzle—didn’t have the same effect. The key, researchers said, is to step outside your comfort zone and keep stretching your mental abilities. Trying new experiences seems to be especially powerful for keeping the brain agile.

While the research doesn’t prove that brain-stretching activities can completely prevent dementia, it strongly suggests that they can delay its onset or lessen its severity. Experts think these habits, combined with a healthy lifestyle—such as regular physical exercise, good nutrition, and quality sleep—offer one of the best defenses we have right now against cognitive decline.

In short, the study encourages people to view the brain as a muscle that grows stronger when challenged. Whether it’s picking up a new skill, reading something complex, or engaging in thoughtful discussions, stretching your mind regularly may help you stay sharp well into old age.

To read the full article click this link: https://www.sciencealert.com/brain-stretching-is-the-secret-to-protecting-your-mind-from-dementia

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Autumn Ayurveda

Ayurvedic Medicine views each season differently, which is one of the things that makes it so incredibly interesting. Our Naturopath and Ayurvedic Practitioner Padi has jotted down some thoughts regarding things to focus on as we enter Autumn, and dropped an update on her next Breathwork Course.

As the weather begins to cool, it’s a beautiful time to gently support the body as we transition into autumn.

One simple ritual I love is a warming digestive tea. You can simmer fenugreek seeds, cinnamon sticks, fennel seeds, grated fresh ginger, and coriander seeds in water, then sip throughout the day or have a cup in the evening. It’s a simple way to support metabolism, digestion, and lymphatic flow. 

Another great way to prepare your body to transition from season to season is your breath.

Here’s something that really stayed with me:

“No matter what we eat, how much we exercise, how resilient our genes are, how skinny or young or wise we are, none of it will matter unless we’re breathing correctly.”

James Nestor also shares in his book that the SKY Breathing practice is one of the most powerful breathing techniques he has ever experienced.

Around 90% of toxins are removed from the body through our breath. Proper breathing improves circulation, lymphatic function, digestion, and every other aspect of our health. The breath holds the power to bring the mind into the present moment, keeping it calm, steady, and focused, while helping regulate the nervous system.

Over the years in clinic, I’ve seen many beautiful tools support healing—but honestly, very few things have come close to the consistent and noticeable impact this breathing practice has had for my patients.

I teach this practice once a month, and I invite you all to join and experience it for yourselves.

Here is the link to look up the research on the SKY breath work :

http://aolresearch.org/

Upcoming workshop :

17-19 April 2026

  • Friday: 6:30 PM – 9:15 PM
  • Saturday: 2:30 PM – 6:00 PM
  • Sunday: 2:30 PM – 6:00 PM

https://aolreg.org/c/AUC1027770

With love, 

Padi 

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Could Ozempic Create Joint Problems?

As researchers dig deeper into the long term effects of drugs like Ozempic and Wegovy, more things are being discovered. A recently published article looked at whether it has a long term effect on bone mineral density as a potential cause of joint issues in the future.

Some medicines called GLP-1 drugs—like Ozempic and Wegovy—help people lose weight and control their blood sugar. But a new study suggests they might also make people a little more likely to get certain bone and joint problems, such as osteoporosis (weaker bones), gout (painful swelling in joints), and osteomalacia (soft bones).

The researchers think this might happen because these drugs can cause fast weight loss, which puts extra stress on the body and changes how nutrients are used. Losing weight too quickly can also raise uric acid, which can trigger gout.

The study looked at the health records of more than 73,000 people who used these drugs and compared them with a similar group who didn’t. The people taking GLP-1 drugs had a slightly higher risk of bone problems—less than 1% more on average—but it was still enough to notice.

Scientists say the study doesn’t prove that the drugs cause these issues, but doctors might want to keep an eye on bone health for patients who could be at risk.

Interestingly, another study found that people on these same drugs may actually recover better from bone and joint surgeries like hip or knee replacements, so it’s not all bad news.

Right now, doctors are still learning about the long-term effects of GLP-1 medicines. They can do a lot of good, but scientists want to make sure they’re safe for bones and the rest of the body too.

Te read the Science Daily report click this link https://www.sciencealert.com/ozempic-like-drugs-may-increase-risk-of-bone-and-joint-conditions

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Scientists create cartilage scaffold that helps the body regrow bone

To read the report or the full study on this, click here.

Researchers in Sweden have created a new type of bone‑repair material made from cartilage that has had all its living cells removed. What remains is the natural framework of the tissue, which still contains signals that help guide the body’s healing process. This scaffold works like a blueprint, giving the body instructions on how to rebuild missing or damaged bone.

Bone injuries—especially large ones—are difficult for the body to fix on its own, and millions of people each year require bone grafts. Current treatments often rely on using a patient’s own tissue, which can be painful, slow, and expensive. The new scaffold offers a possible alternative that doesn’t require taking tissue from the patient, which could make treatment easier and more accessible.

In lab and animal studies, the scaffold encouraged the growth of new bone without causing strong immune reactions. This is important because the immune system normally rejects tissue that doesn’t come from the patient. The engineered cartilage avoids this problem because the cells have been removed, but the supportive structure and helpful growth factors remain.

Another advantage is that the scaffold can be produced in advance using stable, well‑controlled cell lines. Because it doesn’t have to be customized for each patient, it could become an “off‑the‑shelf” option—ready to use whenever someone needs it. This may significantly speed up treatment and reduce costs.

The research team believes this method could someday be used to treat large, difficult bone injuries that currently require complex surgeries. They see it as an important step toward developing universal bone grafts that work for many people without needing personal modifications.

The scientists are now preparing for human clinical trials. They must decide which types of injuries to test first, such as major defects in long bones like the femur or tibia. At the same time, they are building a large‑scale manufacturing process that can produce the scaffolds consistently and safely.

Before testing in humans can begin, the team also needs to complete the documentation required for ethical and regulatory approval. If the early results continue to be positive, this technology could become a major advancement in bone repair and regenerative medicine.

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Can peanut butter improve mobility after 65?

When I saw that headline on the News Medical site it clearly caught my attention. Here is a summary of the article or a link to it if you’d like to read more about the study.

The article covers a randomized controlled trial examining whether daily peanut butter supplementation can improve physical function in adults aged 65 and older, with the key finding being that while one specific measure of lower-body power improved, the study’s primary walking test showed no change.

The scientific backdrop for the study is the well-established decline in muscle mass and strength that accelerates after age 50, with lifetime losses of 20–30% in muscle mass and up to 40–50% in strength. After 65, physical function can drop to less than half its peak capacity, raising the risk of falls, fractures, hospitalization, and loss of independence.

The rationale for focusing on peanut butter stems from its nutritional profile — it is rich in protein, unsaturated fats, vitamins, minerals, antioxidants, and fiber — and from observational data suggesting that regular nut consumption may reduce inflammation and oxidative stress, both of which contribute to muscle decline with aging. Nut butters are also practical for older adults because they are soft, affordable, and easy to incorporate into daily meals.

The trial recruited 120 community-dwelling adults aged 65 and over who were assessed as being at risk of falling. Half were assigned to consume 43 grams of peanut butter per day — roughly 1.5 nut servings, providing 10 grams of protein and 250 calories — while the other half continued their usual diet without nuts, for a period of six months.

The primary outcome — 4-meter gait speed (a standard walking test) — did not improve in the peanut butter group, nor did most other measures of physical function, strength, or body composition. However, there was a meaningful improvement in the five-times sit-to-stand test, with participants completing it about 1.2 seconds faster and showing notable gains in both absolute and relative muscle power.

The researchers note that this improvement in muscle power is potentially clinically significant. Low relative muscle power is a known predictor of limited mobility, and a gain of 0.2–0.3 watts per kilogram can shift someone from a low to a medium or medium to high power category — levels that are more closely tied to independence and survival in older people than peak strength alone. Notably, participants did not gain weight despite the additional calories, which the authors speculate may relate to the high unsaturated fat content of peanut butter and possible effects on energy balance.

Can peanut butter improve mobility after 65? The study had several limitations worth noting, including a relatively high baseline protein intake among participants (which may have limited the room for additional benefit), a comparatively high baseline physical function that could create ceiling effects, no placebo food for the control group, and no measurement of inflammatory or oxidative stress markers to test the proposed biological mechanisms. The authors conclude that while the findings are modest, the simplicity and strong adherence (86%) of the intervention make it worthy of further investigation, particularly among older adults with low muscle mass or those at risk of malnutrition.

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Sleep Matters: Profiling Sleep Patterns to Predict Sports Injuries in Recreational Runners


Recreational running is one of the most popular sports in the world, with over 620 million people running frequently for fun globally. Despite its many health benefits — including physical fitness, stress reduction, and increased life expectancy — running also carries a notably high injury burden, with more than five injuries occurring per 1,000 hours of running. [ABC News](https://abcnews.go.com/Health) It was against this backdrop that researchers set out to explore a factor that had been largely overlooked in injury prevention research: sleep.
The study was led by Jan de Jonge, a work and sports psychologist at Eindhoven University of Technology in the Netherlands and adjunct professor at the University of South Australia. Published in the journal *Applied Sciences*, it surveyed 425 recreational runners and tracked their sleep habits and injuries over the course of a year. [U.S. News & World Report](https://health.usnews.com/wellness) Rather than simply measuring how many hours participants slept, the researchers took a broader view of sleep health.
Instead of focusing only on how long people slept, the researchers also examined sleep quality and the presence of sleep disorders to better understand their combined effect on injury risk. [CBS2 Iowa](https://cbs2iowa.com/news/nation-world/trying-to-improve-your-health-and-wellness-in-2026-keep-it-simple) Using a statistical technique called Latent Profile Analysis, they identified four distinct sleep profiles among the participants: Steady Sleepers, Poor Sleepers, Efficient Sleepers, and Fragmented Sleepers. [Fox News](https://www.foxnews.com/health/6-pillars-healthier-lifestyle-2026-from-experts-staying-young)
The results were striking. Runners who struggled with falling asleep, woke up frequently during the night, or rarely felt rested were the most prone to injury. In contrast, those who maintained consistent sleep schedules and felt well-rested reported significantly fewer injuries. [Prenuvo](https://prenuvo.com/blog/11-exploding-health-trends-you-may-see-in-2026) The difference between these groups was substantial and statistically meaningful.
Participants who reported shorter sleep duration, poorer sleep quality, or frequent sleep problems were 1.78 times more likely to be injured, with a 68% chance of suffering from an injury within 12 months. [U.S. News & World Report](https://health.usnews.com/wellness) The researchers described this as compelling evidence that sleep is a critical — yet routinely underestimated — component of injury prevention for runners.
The biological reasoning behind these findings is well-supported. Sleep is a vital process that allows the body and mind to recover from physical and mental training demands. When sleep is disrupted or insufficient, the body’s ability to repair tissues, regulate hormones, and maintain focus all diminish — each of which can contribute to a higher injury risk. [CBS2 Iowa](https://cbs2iowa.com/news/nation-world/trying-to-improve-your-health-and-wellness-in-2026-keep-it-simple) Sleep deprivation also slows reaction times, reduces coordination, and degrades decision-making, meaning a sleep-deprived runner is more likely to misjudge a movement or lose balance in ways that lead directly to injury. [Fox News](https://www.foxnews.com/health/6-pillars-healthier-lifestyle-2026-from-experts-staying-young)
The study’s authors argue the findings carry important implications for recreational and competitive runners alike, as well as for coaches and health professionals. Runners — especially those balancing training with work, family, and social commitments — may actually need more sleep than the average adult to recover properly. Practical steps such as maintaining a regular bedtime, limiting screen exposure before sleep, reducing caffeine and alcohol intake, and keeping the bedroom quiet and cool can all help improve sleep quality and, by extension, reduce injury risk. [CBS2 Iowa](https://cbs2iowa.com/news/nation-world/trying-to-improve-your-health-and-wellness-in-2026-keep-it-simple) The core message is simple but powerful: how well you rest matters just as much as how hard you train.

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Bicep Tendinopathy

Our Osteopath Marcus wrote this fantastic outline on all things related to bicep tendon injuries. A lot of tendon injuries have similarities in the way they are managed so some of this information would apply to things like and Achilles Tendon injury, Glute Medius tendon, Golfers or Tennis Elbow injuries etc. If you want any more information shoot us an email anytime at harleyplacehealth@gmail.com!

Deep, throbbing pain in the front of the shoulder that worsens with lifting is a typical presentation of Bicep tendinopathy. In this blog we will discuss…  What is Bicep tendinopathy? The causes of Bicep tendinopathy; signs and Symptoms of Bicep tendinopathy; what you can do right now to help; how a physio and osteo can help your Bicep tendinopathy and how long it takes for Bicep tendinopathy to improve. 

  1. What is Bicep tendinopathy?

The bicep in your arm has two muscle bellies. Each of these muscles is connected to the bone via a tendon. At the shoulder, the short head of the bicep is attached to coracoid process of the scapula (shoulder blade). The long head of bicep attaches to supraglenoid tubercle of the scapula, deep inside the shoulder joint. The two bicep bellies share a single tendon at the elbow region and that attaches to the radial tuberosity of the radius, the outside bone of the forearm. 

With a Bicep tendinopathy, we are dealing primarily with the tendon of the long head of bicep. The tendon connected to the long head belly runs along the bicipital groove at the front of the upper arm bone before it travels below the subacromial space at the tip of the shoulder before diving deep into the shoulder joint to attach to the supraglenoid tubercle.

**Record a short anatomy video of the bicep attachment with the model?? DONE

The function of the bicep is to flex the arm at the elbow joint and also stabilize the front of the shoulder. So you can imagine the bicep has a crucial role to play involving any elbow movement and shoulder stability. 

Now you know what the bicep tendon is and where it travels; a Bicep tendinopathy is simply a disorder or a disease of the bicep tendon denoted in the suffix, -pathy.

  1. Causes of Bicep tendinopathy

The causes of Bicep tendinopathy can occur in a variety of ways. A tendon tear can occur even with a health tendon if there is a high impact, sudden and overloaded force going through it such as a throw or a sudden drop of a heavy weight. Another way a Bicep tendinopathy can occur is with repetitive overuse activity leading to the actual tissue cell degeneration of the tendon. In this case, inflammation will occur in response to the damage, the tissue then rebuilds, remodels and regenerates to become healthy tissue once again. Lastly, Bicep tendinopathy can occur via direct trauma, such as a collision in a tackle sport or in rarely cases some type of laceration such as a knife wound. 

With regards to daily activities, Bicep tendinopathy most commonly occur with overhead ball sports, swimming, gymnasts, contact sports and even in individuals would does lots of weight training. Occupations that require similar types of heavy and/or repetitive activities in said position are also likely to experience Bicep tendinopathy. 

  1. Signs and Symptoms of Bicep tendinopathy.

There are a number of different presentations of Bicep tendinopathy. Pain is most commonly felt in the front of the shoulder, it can be felt with or without arm movement.  It can be localized in the groove of the front shoulder arm or it can be vague and broad throughout the whole upper arm. Depending on the type of tendon injury, some clicking or snapping sensation maybe felt with shoulder and elbow movement as well, particularly with overhead movements. 

It is important to know Bicep tendinopathy can commonly present as a result of, or in conjunction with, other shoulder conditions/injuries such as rotator cuff tears and SLAP lesions, therefore it is sometimes necessary to address other factors relating to the shoulder girdle as a whole to resolve and prevent bicep tendon injury from returning. 

  1. What you can do right now for Bicep tendinopathy?

There are several things you can do immediately after suffering from Bicep tendinopathy. First is to rest and not do any activities or put the shoulder in any position that exacerbates the pain. If there are signs of inflammation, using ice for 20min on, then off, then 20min on again is a great way to reduce the inflamed tissues in the shoulder. Short-term use of medication such as NSAIDs is an option, however it should not be a substitute for prolonged relief. 

Seek further investigation with your physio or osteo should the condition not improve. Living with Bicep tendinopathy can drastically diminish your quality of life, as you will find yourself having difficulty with reaching, putting on clothes or carrying even seemingly light objects. 

  1. Physio and osteo treatment for Bicep tendinopathy.

Manual therapy and exercise rehab is the best form of treatment of Bicep tendinopathy. Your practitioner will first take a thorough history of the injury which includes how and when it may have occurred, and any pre-existing conditions that may contribute to the injury.

There are a number of orthopedic tests available to test for Bicep tendinopathy. The most common and useful include the Speed’s, Yergason’s and Bicep Load 2 tests. Imaging such as ultrasound and MRI can be use to confirm severity should the orthopedic test be inconclusive. 

Because a tendon sits between its muscle belly and the bony attachment, we can use muscle tear grading to further rate of level of injury:

– Grade 1 is a mild with minimum loss of strength and motion. Inflammation of irritated surrounding tissues can be present. 

– Grade 2: is a significant loss of strength and motion. These injuries may require two to three months before a complete return to athletics.

– Grade 3: complete rupture of a tendon or muscle. In most cases of complete ruptures, surgery is often required. 

  1. How long until Bicep tendinopathy gets better?

It depends on the type of injury and/or the severity, but it typically ranges from 1week to 3months. A low grade muscle tear will be drastically quicker then say a SLAP tear. Generally speaking, if surgery isn’t required, once the acute phase of pain has settled, exercise rehab can begin. A further decrease in pain as well as improvement in function will set the tone of the intensity and frequency of exercise rehab. 

As previously mentioned, it is important to also address other greater shoulder complex issues to ensure the best motor pattern moving forward. This will ultimately minimize the chance of the Bicep tendinopathy from returning all together. 

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