TL 14

Tom LaFountain

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Bicep subluxation. A nasty injury when it happens. Actually it has happened enough on the PGA and amateur golfers I have worked on over the years to talk about it. As a sports medicine specialist you must refresh your memory on how to reduce a bicep subluxation and be prepared to see it in a golfer. 

Data from Professional Sports Care finds the right bicep to be more vulnerable to this injury than the left in a right handed golfer. It also occurs most commonly on the downswing and acceleration phase of the golf swing. Rapid and forceful internal rotation of the right humerus (arm) with constant tension on the right biceps and wrist extension to square the club face at impact can put the bicep in a vulnerable position. If the golfer's bicep is tight or the bony groove the bicep tendon sits in is shallow the tendon can subluxate. When it does pain is immediate and debilitating in the front of the shoulder and arm. The need for efficient manual therapy to reposition the bicep tendon is at a premium. 

With that said many golfers use core work as the base of their exercise programs. This often leads to incorporating planks into their workout on a regular basis. The golfer must be aware that arm placement with such core exercises is very important. If the humerus (arm) and forearm are not in a neutral position the biceps and rotator cuff will progressively tighten to stabilize the plank. Over time the muscles will tighten to a level where they become more vulnerable to impingement or in the case of the bicep tendon subluxation. I had one such case just two weeks ago. If you have a golfer that utilizes planks in their workout monitor the position of their arms and forearms. Also have them stretch the rotator cuff and shoulder flexors (biceps particularly) to avoid injury. 

Not a common injury but be prepared to treat it. It happens unexpectedly and demands immediate attention.


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