Biceps Tendon Disorders Treatment Options

There are two main biceps tendons—one at the shoulder and one at the elbow. The long head of the biceps tendon attaches inside the shoulder joint, while the short head attaches to the shoulder blade. At the opposite end, the distal biceps tendon connects to the forearm bone (radius). Problems can occur in either location, although shoulder-related disorders are more common.

Biceps tendonitis, a frequent issue, develops when the tendon becomes inflamed from repetitive overhead motion or overuse, often seen in athletes, construction workers, or individuals with physically demanding jobs. Chronic irritation may lead to fraying or small tears, and in more advanced cases, the tendon may rupture completely, resulting in sudden pain, bruising, and a visible change in the contour of the arm known as a “Popeye deformity.”

A physician at OrthoIllinois will perform a thorough examination to determine the type and severity of the tendon disorder. The evaluation includes a detailed medical history, a physical exam to test strength and range of motion, and imaging studies. X-rays may be used to rule out bone abnormalities, while MRI scans or ultrasound can assess the integrity of the tendon and surrounding soft tissues. An accurate diagnosis is key to creating a personalized treatment plan that restores comfort and function.

Most biceps tendon disorders can be treated successfully without surgery. The goal of non-surgical treatment is to reduce pain, restore motion, and strengthen the surrounding muscles.

• The first step is rest and activity modification. Avoiding activities that strain the tendon allows the tendon to heal naturally. Applying ice several times a day can help reduce inflammation and relieve pain.
• Nonsteroidal anti-inflammatory medications (NSAIDs) may be recommended to ease discomfort and swelling. In some cases, a corticosteroid injection is used to provide temporary relief, particularly for persistent shoulder inflammation.
• Physical therapy is a critical component of recovery. A specialized program designed by the OrthoIllinois rehabilitation team focuses on gentle stretching to restore range of motion and progressive strengthening exercises to improve shoulder and arm stability.
• Bracing or the use of a sling may also be suggested for a short period to rest the affected arm, especially if the tendon is partially torn or highly irritated.

If conservative methods fail to relieve symptoms, or if the tendon has completely ruptured, surgical intervention may be necessary. The decision to proceed with surgery depends on the patient’s age, activity level, and the location and severity of the tendon damage.

1. In cases of significant shoulder tendon damage, a biceps tenodesis or biceps tenotomy may be performed.
   • In a biceps tenotomy, the damaged portion of the tendon is released from its attachment in the shoulder joint, which can alleviate pain and prevent further tearing. This option is typically recommended for older or less active patients.
   • A biceps tenodesis, on the other hand, involves detaching the damaged tendon and reattaching it to a new location on the humerus (upper arm bone). This technique restores strength and prevents the cosmetic deformity that can occur with a complete rupture. It is often preferred for younger or more active patients who rely heavily on arm strength.
2. When the distal biceps tendon near the elbow is torn, distal biceps tendon repair is generally required. During this procedure, the surgeon reattaches the tendon to the forearm bone using specialized anchors or sutures. Early surgical repair within a few weeks of injury offers the best chance for full recovery of strength and motion.

All surgical procedures at OrthoIllinois are performed with precision and advanced techniques to promote faster healing and better outcomes. Minimally invasive approaches are often used to reduce scarring, postoperative discomfort, and recovery time.

After surgery, patients typically wear a sling or brace to protect the tendon during the initial healing phase. Physical therapy begins soon after to regain flexibility, followed by gradual strengthening exercises. Recovery times vary depending on the procedure performed and the individual’s overall health, but most patients can expect to return to normal daily activities within three to six months. Athletes and individuals with high physical demands may require a longer rehabilitation period before returning to sports or heavy labor.

Throughout recovery, the team at OrthoIllinois closely monitors progress to ensure the tendon heals properly and function is restored safely.