BICEPS TENDON INJURIES
The biceps tendon is the muscle located at the front of your arm between your shoulder and your elbow. It originates from two separate places in your shoulder. The main bulk of the muscle comes from a bone that is part of your shoulder blade known as the coracoid. This part is virtually never injured and generally does not give problems.
However a small section of the biceps muscle originates from within the shoulder. This is known as the long head of biceps and is a thin cord-like structure that lies partly free within the joint. It is quite a small structure and in many cases probably only plays a very small part in the function of your shoulder. In fact, I have seen three patients who were born completely lacking this tendon.
Unfortunately, this tendon is commonly torn and can give quite significant pain in the shoulder. In the vast majority of patients this tearing comes from age related changes and only in a small number is it torn from an injury.
A torn biceps tendon will give symptoms of pain in your shoulder. Unfortunately it is very difficult to localise this pain and often it is not possible to be sure that any shoulder pain is coming from a biceps tendon tear. Sometimes the tendon is torn completely apart, other times it is just badly frayed and in still other cases, it is painful without having any significant tearing.
In many cases no specific treatment is needed. Sometimes an injection of steroid can help. Occasionally surgery is required. If the tendon is badly torn then it cannot be repaired. There are two options in this case. Firstly, the tendon can be cut completely through and left unattached. Although this seems like a drastic procedure, the tendon often has very limited function and, just like your appendix or your tonsils, you can do without it.
In other cases it may be preferable to preserve this tendon. The torn part is removed and then the tendon is reattached lower down your arm.
With either treatment it is possible that you will notice a change of shape in your upper arm with your biceps appearing more prominent. You may get some aching for some months but this will settle and with either form of treatment you will have an excellent result with no pain and normal function.
The following video shows the surgery.
If surgery is performed you will be able to use your arm for gentle activities straight away. You will need to avoid heavy lifting for about 3 months. However biceps tendon repairs are often associated with a repair of your rotator cuff – and if this is the case you will need a sling for 6 weeks. (see information in the “Rotator Cuff Repair” section of this website).
Surgery for the biceps tendon is usually very safe but of course complications can occur. These are outlined in the ‘Complications Section’ of this website. You should not undergo surgery unless you fully understand the risks. Please contact me if you require further information or an explanation of any part of the surgery.