Biceps tendonitis is a common cause of shoulder pain, generally located at the front of the shoulder. The biceps tendon is located between the shoulder and elbow joints and plays a critical role in elbow flexion and forearm rotation. Certain athletes, such as swimmers and basketball players, are more prone to developing biceps tendonitis because of the repetitive shoulder motions involved in each sport. Dr. Matthew Provencher, orthopedic shoulder surgeon serving the Vail, Aspen and Denver, Colorado area, may recommend a surgical procedure called biceps tenodesis if non-surgical measures do not alleviate shoulder pain and discomfort. A biceps tenodesis procedure is designed to release the tendon, known as tenotomy, at the shoulder joint and reattach it to the humerus (upper arm bone).
The long head of the biceps and the short head of the biceps are the two “bellies” that compose the biceps tendon. The long head is the most commonly injured; it enters the shoulder joint and attaches to the top of the glenoid (socket). Because of its location, the long head must slide back and forth during movement through a tiny groove located at the front of the shoulder joint. This places the tendon at risk for inflammation and irritation, leading to a tear over time in certain patients.
If non-surgical measures do not alleviate shoulder disability and pain associated with biceps tendonitis, Dr. Provencher may recommend an arthroscopic biceps tenodesis. During this procedure, Dr. Provencher will release the tendon from its attachment site inside the shoulder and then reattach the tendon to the humerus (upper arm bone) using small incisions near the front of the armpit. The actual release of the tendon is referred to as a tenotomy. The reattachment of the tendon to the humerus allows it to be located away from the shoulder joint so patients can resume overhead activities.
Dr. Provencher may also recommend an arthroscopic technique called subpectoral biceps tenodesis. This procedure is effective at treating cases of a complete long head of the biceps tendon failure, as well as cases of a failed biceps tenodesis. Subpectoral biceps tenodesis requires Dr. Provencher to perform a tenotomy (release) of the tendon and reattach it to the bone near the inferior (lower) portion of the pectoralis (chest) muscle. This arthroscopic technique is performed through a tiny incision in the armpit, and preserves the biceps tendon length and tension in many cases.
Recovery and Rehabilitation Following Biceps Tenodesis
A detailed physical therapy rehabilitation program will be prescribed by Dr. Provencher following a biceps tenodesis procedure. It is strongly suggested that patients work with the in-house physical therapists at Howard Head Sports Medicine to optimize their rehabilitation. The ultimate goal of physical therapy is to regain joint strength and overall mobility. Many patients can expect to begin range of motion exercises shortly after surgery.
For more resources on biceps tenodesis, or to learn more about the benefits of releasing the biceps tendon (tenotomy) to alleviate biceps tendonitis, please contact the Vail, Aspen and Denver, Colorado orthopedic office of Dr. Matthew Provencher.