Biceps Tenodesis
Biceps tenodesis is a surgical procedure used to treat problems with the biceps tendon, particularly the long head of the biceps tendon. The biceps muscle in the upper arm has two tendons, or “heads,” that attach it to the shoulder. The long head travels through the shoulder joint and attaches inside the socket. Because of its location, this tendon is vulnerable to wear, irritation, and injury. Over time, damage to the long head of the biceps tendon can lead to persistent pain and weakness in the shoulder.
During a biceps tenodesis, the damaged portion of the tendon is detached from its original attachment in the shoulder and re-anchored to the upper arm bone (humerus). This relieves pain caused by inflammation or tearing while maintaining the strength and function of the biceps muscle. The procedure is commonly performed arthroscopically, using small incisions and specialized instruments, although in some cases an open approach may be required.
Biceps tenodesis is typically recommended for patients who have ongoing shoulder pain related to the biceps tendon that has not improved with nonsurgical treatments such as rest, physical therapy, or injections. It is often indicated in the following situations:
- Biceps tendonitis or tendon degeneration: Repeated irritation of the tendon can lead to inflammation and fraying, which causes pain during overhead motion or lifting.
- Partial tears of the tendon: If the tendon is damaged but not completely ruptured ( torn off the bone), tenodesis can remove the painful portion and reattach the tendon securely.
- Instability of the biceps tendon: In some patients, the tendon may slip out of its groove, causing pain and mechanical symptoms.
- Associated shoulder injuries: Many patients undergoing rotator cuff repair or labral repair may also have a damaged biceps tendon. Performing a biceps tenodesis at the same time can improve outcomes.
- Active patients: Tenodesis may be preferred for younger or more active patients because it preserves arm strength and reduces the risk of muscle deformity compared to other surgical options like biceps tenotomy.
Recovery from biceps tenodesis is a gradual process that takes several months and involves a structured rehabilitation plan. The goal is to allow the tendon to heal securely to the bone while restoring shoulder mobility and strength.
- Immediately after surgery: The arm is typically placed in a sling for a few weeks to protect the repair. Patients may experience mild to moderate discomfort, which is managed with pain medication, ice, and rest.
- Early recovery (first 4–6 weeks): During this time, activity is limited. Patients usually begin passive or assisted range-of-motion exercises under the guidance of a physical therapist to prevent stiffness while avoiding stress on the tendon.
- Intermediate recovery (6–12 weeks): The sling is gradually discontinued, and patients work on active range of motion exercises. Light strengthening exercises are introduced to rebuild muscle support around the shoulder and arm.
- Strengthening phase (3–6 months): Progressive resistance training is added, focusing on both the shoulder and elbow muscles. Patients slowly return to normal activities, including recreational exercise, depending on their progress and comfort level.
- Full recovery (6–9 months): Most patients regain full use of their arm, with improved shoulder comfort and function. Athletes and individuals with physically demanding jobs may require longer rehabilitation to safely return to high-level activities.
Every patient’s recovery is unique, and outcomes depend on factors such as age, activity level, the extent of tendon damage, and whether additional shoulder procedures were performed at the same time. Following your surgeon’s instructions and attending all recommended physical therapy sessions are critical to achieving the best results.
At Ortho Illinois, we understand how disruptive shoulder pain can be to your daily activities, whether it limits you at work, in sports, or simply during routine tasks. Our team of fellowship-trained orthopedic surgeons has extensive expertise in diagnosing and treating biceps tendon disorders. We use advanced surgical techniques such as arthroscopic biceps tenodesis to help patients achieve lasting pain relief and restored function.
With five convenient clinic locations—two in Rockford and one each in Algonquin, Elgin, and McHenry—expert care is never far from home. We are dedicated to providing comprehensive orthopedic care, from initial evaluation and imaging to surgery and rehabilitation. Our goal is to create individualized treatment plans that meet your specific needs and support your recovery every step of the way.
If you or a loved one are struggling with persistent shoulder pain, weakness, or limited mobility, the specialists at Ortho Illinois are here to help. Contact us today to schedule an appointment at one of our five convenient locations in Rockford, Algonquin, Elgin, or McHenry. Let our expert team provide the personalized care you need to return to an active, pain-free lifestyle.
