Treatment Orthopedics

Biceps Tendon Injuries
Treatments

For most patients, the initial treatment plan features some combination of these nonsurgical remedies:

  • Rest: If the inflammation is partly due to overuse, resting the shoulder may help.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These oral medications are used to control pain by decreasing the inflammation around the biceps tendon.
  • Strengthening and stretching exercises: Doctors often prescribe a physical therapy program, which may be done at home or under the supervision of a physical therapist. The goal is to strengthen the muscles around the shoulder, which in turn decreases the stress on the inflamed biceps tendon.
  • Corticosteroid injections: Corticosteroids can reduce pain by decreasing inflammation, smoothing the way to recovery. Ultrasound imaging may be used for placing these injections.

    Surgery

    For patients who don't achieve satisfactory results from the treatments discussed above, surgery is an option. The minimally invasive procedure – requiring only a small incision at the front of the shoulder – is called a biceps tenodesis and takes 45 to 60 minutes.

    A majority of biceps surgeries are performed arthroscopically (using an arthroscope, which is an endoscope for joints) at the UCSF Orthopaedic Institute. Patients are under general anesthesia (completely asleep) and given a nerve block (an injection that interrupts pain signals in the area and lessens post-op pain). Other shoulder problems may also be addressed during the procedure. The surgical technique involves changing the tendon's normal attachment point at the shoulder socket to a point farther down the upper arm bone.

    Recovery from Biceps Surgery

    Patients generally must use a sling for four to six weeks to allow the tendon to heal securely in its new position. During that time, driving is restricted and physical therapy is limited to passive range-of-motion exercises, which prevent shoulder stiffness while protecting the repair. Most people with desk jobs can return to work around the second week post-op, but people with active or strenuous jobs may need to complete four months of physical therapy before they can safely return.

    At week six, the sling is removed and physical therapy begins to incorporate active range-of-motion exercises without the use of weights. Patients can resume jogging and doing other lower-body exercises as well.

    At week 12, physical therapy can begin focusing more on building strength. The program generally continues until about month four, and a full return to activities is allowed between five and six months. At six months, the repair is considered completely healed.

    UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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