One of the tendons that is often overlooked as a source of pain on the anterior (front) part of the shoulder 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 resulting a pain that goes down the front of the shoulder and upper arm.
Surgery is frequently performed to help eliminate biceps tendon pain, and is known as a biceps tenodesis. 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 with a small incision near the armpit.
Your arm is placed in a sling for a total of four weeks after surgery, although you may begin some physical therapy beginning at one week post-op. Typical return to day-to-day activities is between eight and twelve weeks after surgery and return to sports, including throwing, begins around three and a half months after surgery. Typical recovery time is four to six months.