Understanding the Basics Behind Biceps Tenodesis
What is Biceps Tenodesis?
The shoulder is both a highly complex joint with many different muscles, tendons, and ligaments working together and a junction between the arm and the rest of your body.
The bicep tendon passes through the shoulder joint and attaches to the labrum, so any damage to these parts of the arm can have a ripple effect.
A tear where the bicep and labrum meet is referred to as a SLAP (superior labrum, anterior to posterior) tear, and a common treatment for this kind of injury is biceps tenodesis. Our highly-trained orthopedic shoulder physicians at Kansas City Orthopedic Alliance have the experience needed to solve a variety of shoulder issues for our patients, including Bankart tears and other injuries to the labrum.
After your initial examination with a KCOA physician, we will recommend the best treatment for your needs. Our practitioners provide the comprehensive care you need so you can return to the activities you enjoy.
Common symptoms of biceps tenodesis include:
- Reduced movement or pain when moving your shoulder
- Shoulder or upper arm weakness
- Numb or tingling sensations in your arms
- Burning sensation in your shoulder or arms
- Completely immobile or “locked” joint
SLAP tears in the labrum can be caused by repetitive shoulder movements or acute trauma. Decreases in shoulder strength and range of motion as well as pain with movement and general instability are all common symptoms of SLAP tears that may require biceps tenodesis in Kansas City.
Kansas City Orthopedic Alliance Shoulder Injuries Assessment
Assessing the Injury
Finding the right shoulder treatment in Kansas City starts with an assessment.
You can think of shoulder pain as a spectrum, with some instances being more severe than others. The KCOA orthopedic specialists always focus on each individual patient and their concerns before creating a treatment plan.
Therefore, during your initial appointment, we will often ask questions such as:
- Does your pain currently limit you or your activities?
- Has your pain progressed or worsened recently?
- Have you experienced any locking in your shoulder or an inability to rotate your arm?
- Have you noticed any change in your symptoms that has made it more challenging to function?
- What are your lifestyle goals?
- How has pain affected those goals?
From there, we can decide which treatment option aligns best with your needs and lifestyle goals. After a proper assessment, we often begin with a physical examination to help determine the origin point of your pain. In some cases, advanced testing may be required for a full diagnosis.
Also called radiographs, an X-ray captures a picture of the shoulder. Orthopedic physicians may order an X-ray to rule out the possibility of a fracture (broken bone), osteoarthritis, or other shoulder-related conditions.
Magnetic Resonance Imaging (MRI)
MRI captures images of muscles, bones, intervertebral discs, and tendons to help provide information other tests can’t detail. During an MRI, you will lie on a table that slides into a tube-shaped scanner. The machine creates a magnetic field around you, using pulsed radio waves to form the MRI images.
Our providers can utilize an arthrogram test to properly diagnose issues with the shoulder joint, including ligament, tendon, and cartilage issues. Our staff will utilize a special dye, which is injected into the joint, to see any potential issues with clear detail.
Establishing a Care Plan
Based on the results of your interview, examination, and imaging studies, you can expect a custom care plan catered specifically to you.
Many people believe it’s best to wait until pain becomes severe, leading them to “put off” or delay treatments.
If you are in constant discomfort, have shooting or stabbing pains, have limited range of motion, or an inability to perform your daily activities, biceps tenodesis may be right for you.
New technologies allow patients with shoulder pain to fully recover and enjoy the benefits of a more functional, pain-free lifestyle.
Prior to surgery, you will typically receive at least 2 phone calls:
- A hospital registration representative will call to gather insurance and other personal information.
- A registered nurse will call to review your health history and medication information.
Dependent on your health history, your physician may require:
- Pre-surgical laboratory tests
- Primary care clearance
Pre-operative instructions will vary depending on your physician and the location of your surgery.
Always check with your physician prior to surgery.
Most physicians require patients to not eat or drink after midnight prior to surgery the next day.
Additionally, you will need a designated family member or friend to drive you home on the day you are released from the hospital. Surgical patients cannot drive themselves home.
Day of Surgery
If you schedule your surgery with a KCOA physician, you can expect the following on surgery day:
- A receptionist will check you in at the hospital registration desk.
- A nurse will take you back and prepare you for surgery. They will start an IV, prepare the surgical site, and review your medical history and medications.
- Your surgeon and anesthesiologist will visit with you prior to your operation.
- The surgical team will take you to the operation suite for surgery.
How it Works
Biceps tenodesis is a procedure that treats SLAP tears in the shoulder, a tear at the junction of the bicep’s tendon and the labrum. This procedure is typically performed through a small incision, usually during a shoulder arthroscopy. If the issue is part of a larger shoulder operation, open surgery may be required.
What happens during open biceps tenodesis?
- Your surgeon cuts into the area where the top of your biceps tendon connects to your labrum.
- They pull your biceps tendon through the incision and release it from your labrum.
- They drill a small hole in your upper arm bone (humerus).
- Your surgeon uses a suture anchor to push your bicep tendon into the hole in your upper arm bone. This technique is the screw fixation technique.
- Your surgeon closes your incision.
After your surgery, you will remain in the recovery room before being discharged. Our experienced clinical team will monitor you during this recovery and provide pain relief medication, if needed.
Recovery from biceps tenodesis takes time. Patients will wear a sling for at least 6 weeks after surgery to protect the repair. The length of recovery time varies by patient, but you can expect several months of physical therapy, in conjunction with a home exercise program, in order to regain functional range of motion and strength.
Because of its proximity to the head and neck and the concentration of nerve endings, shoulder surgeries can cause quite a bit of discomfort. Therefore, after surgery, the shoulder is often very sore, achy, and painful.
This is expected. Keep in mind, the shoulder joint is more complicated than the knee due to its structure and mobility, which is why recovery usually takes longer. Most people are in a sling for at least a month, but for more severe cases, it may be extended to 2 months.
What to Expect
As time passes, you will gradually notice an improvement for up to a year.
To prevent further injuries, it’s important to maintain good posture (ensuring the shoulder is in a good position of the scapula), focus on core strength, and promote healthy mobility of the thoracic spine.
We recommend regular exercise, eating a balanced diet, maintaining a healthy weight, and monitoring your blood sugar levels if you’re diabetic.
Staying active and following the instructions of your providers are key to a successful recovery from biceps tendonitis.
Causes of Shoulder Pain
The body has different kinds of joints, and they all face different challenges. The shoulder is a “ball-in-socket” joint, meaning it’s composed of a ball-like structure that moves inside a depression in the bone to allow for rotational movements. The ball-shaped head of your humerus (upper arm bone) that fits into the glenoid cavity in the scapula (shoulder blade) creates the shoulder joint.
In most instances, pain in your shoulder doesn’t come from these bones unless a fracture is present. Pain generators in the shoulder include disruptions to muscles, ligaments, cartilage, and tendons that surround and support this joint.
Surgery isn’t necessarily the first choice for treatment. Kansas City Orthopedic Alliance physicians prefer a more conservative approach to treatment, so we will typically exhaust all non-surgical options before recommending surgery. Non-surgical treatments for shoulder injuries include:
Physical Therapy – Movement can actually reduce pain and encourage healing in the shoulder, as movement increases circulation in the joint, supplying oxygen and other nutrients that support joint health and function.
Medications – Your doctor may recommend over-the-counter NSAIDs (Non-steroidal anti-inflammatory drugs, such as Advil) or prescription medications. Especially with NSAIDs, you should always talk to your doctor to ensure they are the right treatment for you.
Injections – Cortisone injections can help reduce inflammation in the shoulder and can even provide additional insight into the cause of your shoulder pain. The amount of relief from an injection varies by patient, but often in combination with physical therapy, patients can experience significant improvements in their function.
Regenerative Medicines – Regenerative medicines like stem cell injections or platelet-rich plasma can help nourish worn or damaged tissue. This option works best if you have mild-to-moderate shoulder pain.
Frequently Asked Questions
Kansas City Orthopedic Alliance is here to help.
Our care is personal. Our team is knowledgeable. And we’re more available than ever.
With access to board-certified specialists across Kansas City, we have the tools to meet almost every musculoskeletal condition.
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6 weeks post op and Dr. Brown says I’m progressing well. She’s very knowledgeable, and is very quick to answer any questions I have. She’s also very personable, we laughed a lot during my last appointment. Looking forward to seeing her again.
The first thing that I noticed was the traffic flow. This may sound strange but people were being seen and sent out on their way. There was not a huge roomful of frustrated, tired patients. If most (I assume) had uncomfortable and or painful maladies, they didn’t have to wait forever for attention. That was how it was for me. Professional and personable patient care.
This place is amazing! I cannot say enough good things about our experience here! From the reception desk where they were beyond helpful and even made phone calls for me to my kids pediatrician to very short wait time then the patience and help of doctors and staff that were great with my 3 year old! Getting same day service this great was so nice! Love this place and highly recommend!!
Dr Van Den Berghe and his RNP Shannon are on top of the profession. Great care Great communication. All around great experience
Stephanie took great care in explaining my son’s injury and future implications. I feel like we fully understood the injury and what he needed to do to allow it to heal. I would definitely recommend Stephanie!