Biceps Tenodesis
Biceps tenodesis and tenotomy with Dr. Steven Ward in Tucson and Oro Valley — relieving front-of-shoulder pain from a damaged long head of the biceps tendon.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
The biceps muscle has two tendons at the shoulder. The long head runs through the shoulder joint to the top of the socket, which makes it more likely to become irritated or torn. Surgery on this tendon may be recommended for:
- Biceps tendinitis — pain at the front of the shoulder, worse with overhead lifting or reaching back, sometimes aching down the upper arm
- Partial tears or fraying of the long head of the biceps
- SLAP tears that extend into the biceps attachment, especially in adults
- Biceps instability — the tendon slipping out of its groove, often along with a rotator cuff tear
Biceps problems often occur together with rotator cuff tears, impingement, or labral tears, and these are usually treated at the same surgery.
Is surgery right for you?
Non-operative care works for most people with biceps tendinitis:
- Rest from painful activities, and ice
- Anti-inflammatory medication when it is safe for you
- Physical therapy for flexibility and strength
- A steroid injection around the tendon, often guided by ultrasound
Surgery is considered when symptoms do not improve, or improve and then return. A complete tear of the long head at the shoulder usually does not need surgery; most people keep good function, and the “Popeye” bulge in the arm is mainly cosmetic.
How the surgery is done
Dr. Ward first examines the shoulder arthroscopically to see the biceps tendon and check the rest of the joint. Then one of two procedures is done:
- Tenodesis — the damaged part of the tendon inside the joint is removed, and the healthy remaining tendon is reattached to the upper arm bone with an anchor or screw. This can be done arthroscopically or through a small incision at the front of the upper arm.
- Tenotomy — the tendon is simply released from its attachment. It is the least invasive option with the shortest recovery, but it can leave a Popeye bulge or cause muscle cramping.
The choice depends on your age, activity level, and goals. Dr. Ward will talk through which option fits you.
Often combined with other repairs
Biceps surgery is frequently done at the same time as a rotator cuff repair, subacromial decompression, or labral treatment. When that happens, your sling time and restrictions follow the most protective plan — for a rotator cuff repair, see rotator cuff repair.
Recovery overview
Typical ranges after an isolated biceps tenodesis. Dr. Ward’s plan for you may differ, especially if other repairs are done at the same time.
First few weeks
- Sling for a few weeks while the tendon starts to heal to bone
- Hand, wrist, and gentle elbow motion without resistance
- Ice and scheduled pain control as directed
Weeks 3–6
- Shoulder flexibility exercises begin, at home or with a therapist (formal physical therapy is not always needed)
- Continue avoiding lifting and resisted elbow bending or forearm twisting, commonly for about 6 weeks, so the tendon can heal
Weeks 6–12 and beyond
- Gradual strengthening of the shoulder and arm
- Return to heavier lifting, work, and sports as Dr. Ward clears you
- Most people regain full, pain-free motion; a few high-demand overhead athletes may need to limit some activities
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- New or worsening numbness, tingling, or weakness in the arm or hand once the nerve block has worn off, or fingers that turn pale, blue, or cold
- Pain that is not controlled by your prescribed medication, ice, rest, and the sling
- Swelling, pain, or tenderness in the calf or arm that is new or getting worse
- A sudden pop with new bruising or a bulge in the upper arm
It is normal for the shoulder and arm to feel numb for roughly 12–24 hours after a nerve block, and for the shoulder to be sore and bruised for a while. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Shoulder arthroscopy post-op
Wound care, pain control, ice, and early motion after arthroscopic shoulder surgery.
Open pageRotator cuff repair
What happens when a torn rotator cuff tendon is repaired, and the week-by-week rehab plan.
Open pageExercise guides
Printable home exercise programs to use with your physical therapist.
Open pageShoulder post-op hub
All of Dr. Ward’s shoulder packets, rehab protocols, and anatomy guides in one place.
Open pageOrthoInfo: Biceps tendinitis
Patient education on biceps tendon problems at the shoulder from the AAOS.
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