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Background  This study aimed to investigate the relationship between stiffness of the bicep brachii muscle (BBM) and distal bicep tendon (DBT) and effects of weight lifting (pre- to post-workout changes) among groups with different body mass indexes (BMI).    Methods  Participants were divided into four groups according to BMI: A, underweight (< 18.5 kg/m 2 ); B, normal (18.5–24.9 kg/m 2 ); C, overweight (25.0–29.9 kg/m 2 ); and D, obese (> 30.0 kg/m 2 ). All participants were males who were untrained and had sedentary lifestyle without involvement in sports activities for the past 12 months. Ultrasonographic measurements to determine muscle and tendon stiffness was performed on the dominant side (i.e., right side) of the upper extremities in all participants.    Results  Twenty-one healthy and untrained males volunteered to participate in this study; 14 were nonsmokers and 7 were smokers. The mean age and BMI were 22.5 ± 1.5 years and 23.8 ± 6.3 kg/m 2 , respectively. Groups A, B, C, and D had four, ten, four, and three participants, respectively. The BBM thickness did not increase with increase in BMI and was not significantly different ( P  > .05) between groups. The BBM stiffness was significantly different (all  P  < .05) from pre- to post-workout values in all groups, whereas DBT stiffness did not follow the same trend.    Conclusions  Our study revealed that the BBM thickness is independent of BMI. After weight lifting, BBM stiffness in groups A and B increased for BBM compared to those in groups C and D. A similar trend was also recorded for DBT. Weight lifting in concentric and eccentric motions affects the stiffness of the BBM and DBT, thus weight lifting plays a role in adjusting the stiffness of the BBM and DBT.   Trial registration  The study was approved by ethics committee of the College of Applied Medical Sciences (CAMS 080-3839; March 14, 2018).

Influence of body mass index and weight lifting on bicep brachii muscle and distal bicep tendon stiffness evaluated using ultrasound elastography