Is the biceps the cause of shoulder pain? Let's talk about Biceps Tenodesis!

Does your shoulder hurt all the time? Are you tired of the pain that comes from the inside of your shoulder when you lift weights, play sports, or just raise your arm? Do you sometimes hear a "click" sound in your upper arm and suddenly feel like you're being tossed around with a sharp pain? These could be a problem with a tendon that connects your biceps muscle. So today, let's talk about a surgery called Biceps Tenodesis, which can be a solution to this condition.

Simply put, what is Biceps Tenodesis?

Biceps Tenodesis is a surgical procedure that repairs a tear or damage to the long head of the biceps tendon that connects your biceps muscle to your shoulder. Specifically, this tendon attaches to a piece of cartilage (the labrum) inside your shoulder joint. When this tendon tears or becomes inflamed (biceps tendonitis), it can cause severe pain and weakness in your shoulder and arm.

So in this operation, the surgeon releases the damaged tendon from inside the shoulder joint and reattaches it to the upper arm bone (humerus). This is like removing the broken part of a bridge and attaching it to a new, stronger place.

Will I need this surgery too? What are the symptoms?

See if you have these symptoms to see if it's time for you to consider this surgery.

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. As we age, they are more likely to tear, even with a minor injury.
• Sports: This condition can occur in people who play sports that frequently involve overhead movements (e.g., bowling in cricket, swimming, tennis, volleyball).
• Other shoulder injuries: If the labrum (the cartilage ring around the shoulder joint) is torn (also called a SLAP tear ), the biceps tendon can also tear or tear at the same time.

Surgical procedures and preparation

This surgery can be performed in two main ways: open surgery and arthroscopic surgery.

General preparations before surgery

Your doctor will give you specific instructions, but in general, be careful about these things.

• Avoid eating or drinking for 8 hours before surgery (regular medications, e.g. blood pressure medication, can be taken with a sip of water).
• If you smoke, stop smoking at least two weeks before surgery. This will greatly help your heart and lungs function.
• If you are taking any herbal supplements, talk to your doctor about stopping them a week or two before surgery.

1. Open Surgery (Open Biceps Tenodesis)

This involves making a small incision (about 3-4 centimeters) in the front of the shoulder, taking out the damaged tendon, removing it, inserting it into a small hole made in the upper arm bone, and fixing it with a special suture anchor and screw (screw fixation technique).

2. Arthroscopic Surgery (Arthroscopic Biceps Tenodesis)

This is a 'keyhole surgery'. It does not involve a large incision. Instead, several small holes are made around the shoulder, through which a small camera (arthroscope) and surgical instruments are inserted. The doctor, viewing the images from the camera on a monitor, releases the damaged tendon and reattaches it to the arm bone as before.

What happens after surgery? Recovery time

It usually takes 4-6 months to fully recover. During this time, you will need to be patient.

• Arm Sling: You will need to wear an arm sling for about 2-6 weeks after surgery. During this time, you may need help with daily activities and driving.
• Physical Therapy: This is an essential and important part of the healing process. A few weeks after surgery, you will begin exercises under the guidance of a physical therapist. This can help rebuild the range of motion and strength of the shoulder.
• Resuming activities: Always talk to your doctor before starting activities like exercise, sports, or weight lifting. If you start working out too quickly, you could re-injure the healing tendon.

When to call a doctor immediately

If anything like this happens after surgery, notify your doctor or hospital immediately.

• If the wound is bleeding so much that the bandage is soaked.
• If you have severe pain that cannot be controlled even with painkillers.
• If the swelling in your hand increases.
• If you have numbness or a feeling of numbness in your fingers or hand.
• If your hand or fingers change color (darken) or feel cold to the touch.
• If there is redness, swelling, pain, or yellow pus-like fluid draining from the wound.
• If you have a fever (over 101°F / 38.3°C).

The success rate of this surgery is more than 70%. Therefore, if you get a correct diagnosis, have the surgery performed by a qualified doctor, and follow the instructions exactly, you can get rid of this annoying shoulder pain and return to your normal life.

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