Is Biceps Tenodesis The Best Shoulder Treatment For You?

Medically Reviewed By:

Dr. Chaz Fausel, MD

Dr. Chaz Fausel is a Denver-based interventional orthopedics specialist and Regenexx educator, trained at Emory and the Centeno-Schultz Clinic.

Biceps tenodesis is a common surgical procedure used to address certain shoulder conditions involving the biceps tendon. However, questions remain about its long-term effectiveness and necessity. Some patients report post-surgical complications or limitations, prompting interest in whether alternative approaches may better support shoulder function.

What Is Biceps Tenodesis?

During a biceps tenodesis procedure, a surgeon detaches the long head of the biceps tendon (as shown in the diagram) from its attachment at the top of the shoulder joint socket and reattaches it elsewhere, often securing it lower in its groove.

Surgeons commonly perform this procedure in older patients when the tendon becomes inflamed, often as part of a rotator cuff repair. In younger patients, biceps tenodesis may address a superior labrum anterior to posterior (SLAP) tear, which affects the upper part of the labrum—the cartilage rim surrounding the shoulder socket.

The procedure aims to relieve stress on the biceps tendon or, in cases of a SLAP tear, to reduce strain on the superior labrum during healing.

When Is Biceps Tenodesis Recommended?

This procedure may be considered when biceps tendonitis or tendon tears persist despite conservative treatments such as rest, physical therapy, medications, or guided injections.

What To Expect After Biceps Tenodesis Surgery

Biceps tenodesis may reduce pain and improve shoulder function in patients who have not found relief through non-surgical treatments. Many individuals report improved mobility and decreased discomfort following the procedure.

However, ongoing care plays a critical role in achieving the best potential outcomes. Regular follow-up appointments allow physicians to monitor recovery and address potential concerns early. While some patients experience positive results, recovery can involve stiffness, discomfort, or other complications.

Understanding these factors can help set realistic expectations and guide post-surgical rehabilitation.

Recovery Duration For This Procedure

Recovery time after biceps tenodesis varies based on the specific procedure and the patient’s overall health. In most cases, full recovery takes several months, with rest and rehabilitation essential in restoring function and mobility.

Physical therapy is a critical component of the recovery process, typically lasting four to six months. While some individuals regain strength and flexibility more quickly, others may require additional time. A structured rehabilitation plan, proper follow-up care, and effective pain management may help support optimal recovery outcomes.

Possible Risks And Side Effects Of This Procedure

As with any surgical procedure, biceps tenodesis carries risks. Possible complications include infection, failure of the tendon anchor, and persistent pain. Some patients may also experience muscle soreness, stiffness, or limited range of motion during recovery.

A 2016 publication identified additional concerns, such as cosmetic deformity of the arm (Popeye deformity), cramping or soreness in the biceps muscle, and reduced biceps strength, which may affect elbow and forearm movements. Understanding these risks is essential when considering biceps tenodesis and exploring alternative treatment options.

Muscle Discomfort

Patients often experience cramping and soreness in the biceps muscle after biceps tenodesis surgery. Symptom intensity varies, ranging from mild to more pronounced discomfort. While these effects are usually temporary, following a structured recovery plan and maintaining open communication with a physician may help manage symptoms effectively.

Loss Of Function

Biceps tenodesis may affect how the arm functions in daily activities such as lifting objects or turning doorknobs. Weakened biceps function may make bending the elbow or rotating the forearm more challenging. While rehabilitation and physical therapy may help restore movement, some patients may experience lasting impairments that impact routine tasks.

Infection

Infection can occur after biceps tenodesis surgery, posing a risk to healing and recovery. Common signs include redness, swelling, and fever at the surgical site. Following post-surgical care instructions, including proper wound care and symptom monitoring, may help reduce the risk of infection and support optimal recovery.

Limited Range of Motion

Biceps tenodesis can lead to a restricted range of motion, often caused by swelling or weakness in the shoulder. Physical therapy and rehabilitation exercises play a key role in improving mobility. Adhering to a structured rehab plan may help restore the full range of motion and support the best possible recovery.

Nerve Damage

Biceps tenodesis can sometimes cause numbness or tingling, often due to temporary nerve irritation. These sensations typically resolve over time, but persistent or worsening symptoms may indicate an underlying issue. Consulting a physician promptly can help address concerns and support a smoother recovery.

Development Of Chronic Conditions

Prolonged stiffness or immobility after biceps tenodesis can contribute to chronic conditions such as frozen shoulder or biceps tendonitis. Frozen shoulder limits mobility and causes joint stiffness, while biceps tendonitis results from tendon irritation or overuse. Following a structured rehabilitation plan helps reduce these risks and supports long-term shoulder function.

A Study Questioning The Effectiveness Of Biceps Tenodesis Surgery

The most reliable way to assess the effectiveness of biceps tenodesis is through randomized studies comparing the procedure to a control group receiving sham surgery. However, like many orthopedic procedures, few such studies exist. A review of the available research identified only one relevant study.

This study focused on patients with type-2 SLAP tears, a common injury where the biceps attaches onto the rim of torn labral tissue.. Researchers divided participants into three groups:

• Sham surgery group: Physicians withheld surgical intervention.
• SLAP repair group: Surgeons sutured or anchored the torn labrum.
• Biceps tenodesis group: Surgeons relocated the biceps tendon to reduce stress on the superior labrum.

The results showed no significant difference in outcomes between the SLAP repair, biceps tenodesis, and sham surgery groups. In other words, patients who received surgery did not experience better results than those who underwent a placebo procedure.

While this raises questions about the value of surgical intervention for certain patients, more research is needed. Treatment decisions should be personalized based on symptoms, imaging, and patient goals.

Is Surgery The Only Choice For Shoulder Repair?

No, surgery is not the only option for addressing shoulder injuries. While physicians may recommend procedures like biceps tenodesis in certain cases, non-surgical alternatives may offer viable options with fewer risks. Physicians in the licensed Regenexx network provide a non-surgical option for treating shoulder injuries using the Regenexx approach.

This approach involves using orthobiologic injectates processed with Regenexx processing to support the body’s natural healing processes. This may help improve function and reduce pain while minimizing downtime and potential complications associated with surgery.

Exploring non-surgical options may help in making informed decisions about care and identifying the most appropriate treatment for a specific condition.

Other Conditions That May Benefit From Procedures Using Regenexx Injectates

Procedures using Regenexx injectates may benefit a range of shoulder conditions by supporting the body’s natural healing processes. Patients experiencing the following shoulder-related issues may find orthobiologic approaches to be viable alternatives:

Discover Non-Surgical Methods That Support Shoulder Function

Physicians in the licensed Regenexx network offer non-surgical alternatives that may help improve tendon and joint health. These procedures use Regenexx lab-processed injectates, such as platelet-rich plasma (PRP) and bone marrow concentrate (BMC), to help support the body’s natural repair processes.

Using advanced ultrasound and fluoroscopic guidance, physicians can precisely target areas of tissue damage, such as inflamed tendons or weakened shoulder structures, to help promote function and mobility.

By addressing the root cause of pain rather than removing or reattaching the tendon, these image-guided procedures may offer a less invasive alternative for individuals considering biceps tenodesis. To learn whether this approach may align with treatment goals, consultation with a physician within the licensed Regenexx network is recommended.

Medically Reviewed By:

Dr. Chaz Fausel, MD

Dr. Chaz Fausel is a Denver-based interventional orthopedics specialist and Regenexx educator, trained at Emory and the Centeno-Schultz Clinic.