Biceps Tendon Overview
One of the tendons that was frequently overlooked in the past as a potential source of pain is the biceps tendon. The biceps muscle is the large muscle on the front part of the arm that we use to flex up the elbow and rotate the forearm. The biceps muscle has a tendon that begins inside of the shoulder joint, and this tendon is very closely related to the rotator cuff. The biceps tendon is highly susceptible to a tear or injury if other tendons (such as the subscapularis or the supraspinatus of the rotator cuff) are torn as well.
Overhead sports, such as volleyball, tennis and baseball, can cause a tear to the biceps tendon or its origin inside the shoulder joint, resulting in a pain that goes down the front of the shoulder and upper arm.
Surgical Options for Biceps Tendon Pain
The term bicep “tenodesis” refers to the biceps tendon (“teno”) being surgical fixed (“desis”) to the bone. A surgery called bicep tenodesis can be performed to help eliminate biceps tendon pain. This procedure can be done arthroscopically or through a mini-incision of the skin without any further damage to the surrounding muscles, which means a faster recovery and less post-operative pain than other major shoulder surgeries.
Using small arthroscopic incisions, the damaged biceps tendon is released from its attachment in the shoulder joint. The upper, or inflamed portion of the tendon, is then removed and the remaining healthy portion of the tendon is anchored to the bone either through an all-arthroscopic technique, or with a small incision near the armpit.
Want to learn more? In this video, Dr. Romeo discusses subpectoral biceps tenodesis.
Biceps Tenodesis Recovery
After surgery, your arm will be placed in a sling for a total of four weeks to protect the tenodesis site. It is important to realize that while the fixation is very strong, the repetitive use of your arm resulting in bending your elbow up and down will put stress on the repair site as it heals. This movement, even without lifting objects in your hand, can have a similar effect to taking a metal clothing hanger and repetitively bending it back and forth until the very strong material breaks or separates.
After the first postoperative visit physical therapy, some gentle exercises for range-of-motion of the elbow and strengthening the fingers and hand will be started. Return to day-to-day activities is usually between six to eight weeks after surgery and return to sports, including throwing, begins around three months after surgery. Typical recovery time is four to six months. For people who like to lift heavy weights, either in the gym or at work, it can take up to 9-12 months to achieve the same maximum strength at the opposite bicep muscle.
For more information about bicep tendonitis, please request an appointment with experienced Chicago orthopaedic surgeon Dr. Anthony Romeo. Call or email our office today to schedule your visit.
Biceps Tenodesis & Shoulder Surgery Videos
Proximal Biceps Tendon (Biceps Tenodesis Repair)
Anatomy of the Shoulder as it relates to Surgery
Animation of Biceps Tenodesis
Additional Links on Biceps Tendonitis
Here are some recent medical journal articles that Dr. Romeo wrote on the topic:
- Superior Labral Anterior Posterior Repair and Biceps Tenodesis Surgery: Trends of the American Board of Orthopaedic Surgery Database
- Trends in Open and Arthroscopic Long Head of Biceps Tenodesis
- Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodeses Produce Similar Outcomes: A Randomized Prospective Analysis. Arthroscopy
- Management of Failed Proximal Biceps Surgery: Clinical Outcomes After Revision to Subpectoral Biceps Tenodesis
- Biomechanical Analysis of All-Suture Suture Anchor Fixation Compared With Conventional Suture Anchors and Interference Screws for Biceps Tenodesis
- Biceps Tenodesis Is a Viable Option for Management of Proximal Biceps Injuries in Patients Less Than 25 Years of Age
- A biomechanical comparison of two arthroscopic suture techniques in biceps tenodesis: whip-stitch vs. simple suture techniques
- Trends in the Management of Isolated SLAP Tears in the United States
- Predictive Factors and the Duration to Pre-Injury Work Status Following Biceps Tenodesis
- Arthroscopic Suprapectoral Biceps Tenodesis With Tenodesis Screw
- Management of Biceps Tendon Pathology: From the Glenoid to the Radial Tuberosity
Anthony Romeo, MD
Dr. Anthony Romeo is one of the nation’s leading orthopaedic surgeons specializing in the management and surgical treatment of shoulder and elbow conditions. His state-of-the-art practice employs minimally-invasive arthroscopic techniques to accelerate the recovery process for a range of challenging conditions.