Pain, weakness, and clicking at the front of the shoulder, especially while lifting or reaching overhead, can sometimes come from damage to the long head of the biceps tendon.
When these symptoms persist despite appropriate non-surgical treatment, biceps tenodesis may be considered. Shoulder specialist Dr. Kevin Kruse and his clinical team evaluate the entire shoulder to determine whether damage to the biceps tendon is the main source of symptoms, whether another shoulder problem is contributing, and which treatment approach makes the most sense.
What Is Biceps Tenodesis?
Biceps tenodesis is a shoulder procedure used to treat pain or damage involving the long head of the biceps tendon. This tendon travels from the upper arm into the shoulder joint and attaches to the top of the glenoid near the labrum. When it becomes inflamed, frayed, unstable, impinged, or partially torn, you may experience pain at the front of the shoulder, clicking, cramping, or weakness while lifting.
During the procedure, the damaged portion of the long head of the biceps tendon is released from its attachment on the glenoid and secured to the upper portion of the bicipital groove. Moving the tendon attachment away from the shoulder joint can lessen pain while helping preserve the normal contour and function of the biceps muscle.
A careful shoulder evaluation helps determine whether damage to the biceps tendon is actually contributing to your symptoms or whether another shoulder condition is the more likely cause.
Conditions Treated With Biceps Tenodesis Surgery
Biceps tenodesis is most commonly considered for:
- Long head of the biceps tendinitis or tendinopathy
- Partial tearing or fraying of the biceps tendon
- Biceps tendon instability or subluxation
- Superior labrum anterior-to-posterior (SLAP) tears involving the biceps anchor
Biceps tendon damage can also occur alongside other shoulder conditions, particularly rotator cuff or labral injuries. In these cases, biceps tenodesis may be performed as a secondary procedure while the primary shoulder problem is addressed.
Symptoms alone do not determine whether a biceps tenodesis procedure is necessary. Front-of-shoulder pain may also come from the rotator cuff, labrum, arthritis, stiffness, or other structures, which is why getting the correct diagnosis comes first.
Benefits Of Biceps Tenodesis
For the right patient, biceps tenodesis can reduce pain and improve comfort with overhead reaching, work, exercise, and recreational activities.
Because the tendon is secured rather than simply released, tenodesis can also help preserve the normal length and tension of the biceps muscle. This can reduce the risk of persistent biceps cramping and the noticeable “Popeye” deformity that can occur when the tendon is released without reattachment.
The decision to proceed with biceps tenodesis is individualized based on the condition of the tendon, other shoulder findings, your symptoms, and your lifestyle and goals.
What To Expect From Biceps Tenodesis Surgery In Dallas
Biceps tenodesis is an outpatient procedure and is most often performed arthroscopically through small incisions. Patients typically return home the same day and use a sling for comfort.
It is also very common for biceps tenodesis to be performed as a secondary procedure during a rotator cuff repair or another primary shoulder procedure. When multiple structures are treated, the recovery plan is based on the complete operation rather than the tenodesis alone.
Protecting the new tendon attachment is important while it heals. You can expect temporary lifting restrictions of approximately 5-10 pounds with the elbow kept at the side and less than 3-4 pounds when the hand is extended away from the body. These lifting limits are gradually increased as the tendon heals and rehabilitation progresses.
Dr. Kruse and his specialized medical team reviews the complete procedure plan and expected recovery with each patient before the procedure.
How To Prepare For Surgery
Preparing for biceps tenodesis is similar to preparing for most outpatient shoulder procedures.
Before the procedure, you may be asked to complete any required medical clearance, review prescription medications and supplements with the surgical team, and stop certain medications when instructed. Follow the specific fasting instructions provided by the surgical team, including when to stop eating or drinking before your procedure.
Arrange transportation home, wear loose or front-button/front-zippered clothing, and plan for help with children, pets, or household tasks that require lifting. If possible, pick up prescribed medications before the procedure so everything is ready when you return home.
Knowing your expected lifting restrictions ahead of time also makes it easier to plan for work and daily activities during the first several weeks of recovery.
Recovery And Rehabilitation After Biceps Tenodesis
Most patients are cleared for light daily activities within days after biceps tenodesis, but lifting and strengthening need to progress carefully while the tendon heals.
Physical therapy begins with range-of-motion progression and gradually advances into strengthening and a return to work, sports, or recreational activities. More substantial strengthening is generally advanced around three months after the procedure.
Complete recovery commonly takes approximately four to six months, although the timeline can change when biceps tenodesis is performed with a rotator cuff repair, labral repair, or another shoulder procedure.
Dr. Kruse’s team provides rehabilitation instructions based on the actual procedure performed rather than using a one-size-fits-all recovery timeline; his team also helps coordinate postoperative rehabilitation.
Why Choose Dr. Kevin Kruse For Biceps Tenodesis Surgery?
Biceps tenodesis isn’t the right choice for every patient, but for the right patient, it can help reduce pain and improve shoulder function.
Dr. Kruse will help you understand your diagnosis, the non-surgical options available to you, any procedures being considered, and your expected recovery timeline so that you can make an informed decision.
Dr. Kruse is a shoulder specialist with extensive experience performing biceps tenodesis and treating both isolated biceps injuries and more complex conditions involving the rotator cuff, labrum, instability, stiffness, and other shoulder structures.
His practice is dedicated exclusively to shoulder care and maintains a high procedural volume. Dr. Kruse is supported by an experienced clinical team that helps provide a streamlined, coordinated approach from diagnosis through recovery.
Schedule A Consultation
If pain at the front of your shoulder, painful clicking, weakness, or difficulty with overhead activity is limiting what you can do, an evaluation can help determine whether the biceps tendon is involved and what treatment makes sense for your shoulder.
Dr. Kruse and our clinical team see patients in Dallas and Plano, Texas. Call 214-750-4590 or submit a scheduling request through our website to book an appointment.
Frequently Asked Questions About Biceps Tenodesis
How long does it take to recover from biceps tenodesis surgery?
Complete recovery commonly takes about four to six months, depending on rehabilitation and whether another shoulder procedure was performed at the same time. Most patients return to light activities of daily living much sooner, typically within several days to a couple of weeks.
Will I lose strength in my arm after biceps tenodesis?
Temporary weakness is expected during recovery while the tendon heals and strengthening is limited. After rehabilitation, most patients regain functional strength without permanent strength loss.
What are the risks of biceps tenodesis surgery?
Potential risks include infection, bleeding, stiffness, nerve injury, persistent pain, tendon re-tear or anchor failure, muscle cramping, and a change in biceps contour. Dr. Kruse reviews the risks that apply to your health and specific procedure before treatment.
Is biceps tenodesis an outpatient procedure?
Yes. When performed in isolation, biceps tenodesis is an outpatient procedure that takes approximately 10 minutes. Patients typically return home the same day. The overall procedure time will be longer when tenodesis is combined with a rotator cuff repair or another shoulder procedure.
When can I return to work or sports after surgery?
Return to work or sports depends on your job demands, activity, and whether another procedure was also performed. Desk work may be possible within several days to two weeks, while heavy labor, lifting, and sports commonly require three months or longer.
Can biceps tenodesis be performed alongside other shoulder procedures?
Yes. Biceps tenodesis is frequently performed with rotator cuff repair, labral repair, shoulder decompression, or another arthroscopic shoulder procedure. When procedures are combined, the rehabilitation plan and recovery timeline are based on everything that was treated.
