What is a biceps tenotomy?

The biceps muscle in the upper arm connects to the shoulder through a tendon. When this tendon is injured or torn, inflammation can cause severe pain in the shoulder. Biceps tenotomy or tenodesis is the surgery done to treat bicep injuries. This surgery may be done alone or as part of larger shoulder surgery.

What does treatment involve?

A biceps tenotomy is done under general anaesthesia. Dr Heymans will make an incision to gain access to the biceps tendon, and detach it. By detaching it, the pain is relieved. While it may be thought that the shoulder stability would be affected, it isn't affected. The function of the biceps is still intact, the appearance of the bicep is however affected as it may cause a flattening on top of the bicep and fullness in the elbow.

Repetitive turning motions and weightlifting may cause spasms in the biceps after this procedure. In cases where patients are very physically active, a different surgery, a biceps tenodesis, may be done. This also involves the detachment of the tendon but is instead reattached to the humerus using screws. This procedure carries less risk for developing the appearance deformity that a tenotomy does.

What can I expect in terms of recovery?

Swelling, pain and stiffness in the arm and shoulder may be expected after a biceps tenotomy or tenodesis. When you wake up, your arm will be placed in a sling to immobilise the shoulder and arm while the tendon heals. After roughly 6 weeks, the sling is removed, and Dr Heymans will advise physiotherapy to help you strengthen the shoulder and biceps. You should be able to return to normal activities in 6 - 8 weeks of surgery, but heavy lifting may only be done after 4 months.