Have you ever had a sharp pain in your shoulder that sometimes makes a clicking sound when you lift something heavy? Or do you suffer from shoulder pain that doesn't go away no matter how much medicine you take or how much rest you take? The cause of this could be an injury to the tendon at the top of your biceps muscle. Today, we're going to talk about a special surgery that's done for just such a situation.
What is this surgery called Biceps Tenodesis?
Simply put, Biceps Tenodesis is a surgical procedure that repairs the tendon that connects your biceps muscle to your shoulder when it is torn or damaged. This tendon damage is sometimes referred to as ``Biceps Tendonitis'' by doctors. This surgery involves releasing the damaged tendon from the shoulder joint and reattaching it to the upper arm bone (humerus). This relieves pain and restores strength in the arm.
Will I need this surgery too? What are the symptoms?
There are several signs that suggest you may need this surgery. Let's take a look at what they are.
| Symptom | What does this mean? |
|---|---|
| Persistent shoulder pain | Pain in the front of the shoulder that does not subside despite rest, physical therapy, or painkillers. |
| Hearing a 'click' or 'snap' sound | Suddenly, you hear a loud noise accompanied by sharp pain in your shoulder or upper arm. |
| Cramps | The feeling of the muscles in the upper arm rolling, especially when lifting a heavy object. |
| "Popeye" Bulge | When the tendon is completely torn, the biceps muscle curls down and looks like a ball, just like in the 'Popeye' cartoon. |
| Bruising and swelling | A bruise or swelling can be seen from the shoulder to the elbow. |
| Inability to turn the arm | It becomes difficult to rotate the hand so that the palm is facing up. |
Why does this biceps tendon tear?
There may be several reasons for this.
- Aging: Over time, the tendons in our bodies wear down and weaken, making them more likely to tear even with a minor injury.
- Sports: This injury is common in people who play sports that require the arm to be held above the head, such as baseball, tennis, and swimming. Repeated movements can damage the tendon.
- Other shoulder injuries: Sometimes the cartilage inside the shoulder joint tears (a SLAP tear). When this happens, the biceps tendon that is attached to it can also tear or detach.
The two main ways in which surgery is performed
This surgery is performed mainly in two ways: open surgery and arthroscopic surgery.
| Feature | Open Surgery | Arthroscopic Surgery |
|---|---|---|
| How to do | A small incision (3-4 cm) is made in the front of the shoulder, the damaged tendon is removed, a small hole is drilled in the arm bone, and the tendon is reattached to it. | The surgery is performed by making several very small incisions around the shoulder, through which a small camera (arthroscope) and instruments are inserted. |
| Scars | A small scar is left. | Only a few very small, barely noticeable scars remain. |
| Pain and healing | While pain may be slightly increased after surgery, some studies suggest that players may be able to return to play sooner. | There is less pain after surgery, and the recovery time may be shorter. |
| Complications | Blood clots, infections, nerve damage, and stiffness can occur. | Blood clots, infections, and stiffness can occur (risk of nerve damage is low). |
The most important thing is that your doctor will decide which surgical procedure is best for you, so talk to him or her about it.
What happens after the surgery?
Even if the surgery is successful, your dedication is also very important for proper recovery.
- Wearing an Arm Sling: You will need to wear an arm sling to rest your arm for 2 to 6 weeks after surgery.
- Pain Management: You may experience some pain in the first few days. Use painkillers as prescribed by your doctor. Applying ice packs can help reduce swelling and pain.
- Physical Therapy: This is an extremely important part of the healing process. After a few weeks, you should begin exercises under the guidance of a physical therapist, as directed by your doctor. This will help you gradually regain mobility and strength in your shoulder.
- Complete recovery: Complete recovery usually takes between 4 and 6 months, but this time can vary from person to person.
Don't rush! If you start lifting weights or playing sports before it's completely healed, the tendon could tear again. So be patient until your doctor says "OK."
Is there an alternative?
Yes, there is another surgery called ``Biceps Tenotomy''. This only involves cutting and releasing the damaged tendon from the shoulder joint; it is not reattached to the bone. Although this is a simple surgery, there is a high chance of a "Popeye" bulge developing after the surgery.
When to see a doctor immediately
If you experience any of the following symptoms after going home after surgery, call your doctor immediately or go to the nearest hospital's Emergency Department (ETU).
- If the cut is bleeding heavily and does not stop even when pressed.
- The pain is so severe that it can't be controlled even with painkillers.
- If the swelling in your hand is getting worse.
- Numbness or loss of feeling in the fingers or hand.
- Discoloration of the hand or fingers (blue/black) or unusually cold hands.
- Redness, swelling, increased pain, or pus-like fluid draining from the surgical site.
- Fever (over 101 F / 38.3 C).
Take-Home Message
- Biceps Tenodesis is a very successful surgery for shoulder pain caused by a biceps tendon tear. It has a success rate of over 70%.
- It can take 4-6 months to fully recover, and it is very important to be patient during this time.
- Physical therapy is an essential part of the healing process. Don't skip it.
- Do not resume lifting weights or playing sports without your doctor's advice. Doing so may cause a recurrence of the injury.
- If you have any questions about your condition, the surgery, or the recovery process, don't be afraid to ask your doctor.
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