Understanding Biceps Tenodesis
If you’ve been experiencing persistent pain in the front of your shoulder, especially with lifting, reaching, or overhead activities, and sometimes a clicking or popping sensation, your doctor might talk to you about Biceps Tenodesis. This surgery aims to relieve pain by addressing a problem with one of the tendons of your biceps muscle in your shoulder.
What’s Going On with Your Biceps Tendon in the Shoulder?
Your biceps muscle, the one that makes a “flexed” arm, actually starts with two tendons (called heads) that attach it to your shoulder blade. The long head of the biceps tendon is particularly prone to problems because it travels through a narrow groove in your shoulder joint and over the top of the humerus (upper arm bone).
Problems with this tendon can arise from:
- Inflammation (Tendonitis): The tendon can become irritated and swollen, causing pain.
- Tears: Small or large tears can develop in the tendon, often from overuse or injury.
- Degeneration: Over time, the tendon can simply wear down and fray, losing its healthy structure.
- Instability: The tendon can slip out of its groove, causing popping or clicking sensations.
When the long head of the biceps tendon is inflamed, torn, or unstable, it can be a significant source of pain in the front of your shoulder, often making it difficult to lift, carry, or perform overhead movements. Sometimes, if the tendon completely tears, the muscle can “ball up” lower in the arm (a “Popeye” deformity), though this often causes less pain than a partial tear or inflammation.
How Does Biceps Tenodesis Help?
Biceps tenodesis is a surgical procedure performed to address these painful issues with the long head of the biceps tendon. The goal is to remove the painful, problematic part of the tendon from within the shoulder joint and reattach the healthy portion of the tendon to a new, more stable location on the upper arm bone (humerus), typically outside the shoulder joint itself.
During the surgery, the surgeon will:
- Access the Tendon: This procedure can be performed using arthroscopy (small incisions with a camera) or a small open incision, depending on the specific technique and surgeon’s preference.
- Detach the Problematic Part: The surgeon detaches the diseased or painful portion of the long head of the biceps tendon from its original attachment point inside the shoulder joint.
- Reattach the Tendon: The remaining healthy part of the biceps tendon is then securely reattached to the humerus bone, often using screws, buttons, or sutures. This new attachment point takes the tension off the damaged area within the joint and places it in a less painful, more stable location. The biceps muscle continues to function, allowing you to bend your elbow and rotate your forearm.
Life After Biceps Tenodesis:
After your biceps tenodesis, physical therapy is a crucial part of your recovery to regain full strength and motion in your arm and shoulder. Your physical therapist will guide you through a structured rehabilitation program, which typically includes:
- Protecting the Repair: Initially, your arm will likely be in a sling to protect the newly attached tendon and allow it to heal firmly.
- Gradual Movement Restoration: As the tendon heals, you’ll begin gentle, controlled exercises to slowly regain the range of motion in your shoulder and elbow.
- Progressive Strengthening: Your therapist will introduce strengthening exercises for your biceps, rotator cuff, and other shoulder muscles. This is vital for rebuilding arm strength and overall shoulder stability.
- Functional Return: As you progress, your therapist will help you gradually return to your daily activities, work tasks, and sports, focusing on proper mechanics to protect your shoulder.
Recovery from biceps tenodesis is a gradual process that requires patience and dedication, often taking several months for a full return to demanding activities. Following your physical therapist’s instructions closely is key to achieving the best possible outcome and safely returning to your desired activities with a stronger, pain-free shoulder.