Proximal biceps tenodesis and tenotomy are surgical procedures to treat issues with the biceps tendon near the shoulder. Often recommended for patients with chronic shoulder pain or instability due to biceps tendon tears or inflammation, these procedures provide pain relief and restore function. For those in Nebraska and Iowa seeking relief from biceps-related shoulder issues, this guide can help you understand the treatment options and what to expect pre- and post-operatively.
What is Proximal Biceps Tendon Pain?
The proximal biceps tendon attaches the biceps muscle to the shoulder joint. Due to repetitive overhead activities, aging, or injuries, this tendon can become damaged, leading to:
- Pain in the Front of the Shoulder: Discomfort, particularly with lifting or reaching overhead.
- Weakness: Difficulty with daily tasks involving lifting or pulling.
- Biceps Deformity: In severe cases, the tendon may partially tear, causing a visible bulge in the upper arm (known as a “Popeye” deformity).
Tenodesis vs. Tenotomy
Both procedures address biceps tendon pain, but they differ in technique and the intended outcome.
- Biceps Tenotomy: The tendon is simply cut from its attachment to the shoulder joint, releasing the tension. This option is generally faster with minimal recovery time but may lead to a slight loss in strength or a visible bulge in the biceps.
- Biceps Tenodesis: The damaged portion of the biceps tendon is removed, and the healthy tendon is reattached to the humerus (upper arm bone). This procedure is typically recommended for younger, active patients, as it preserves biceps function and minimizes the chance of deformity.
Preparing for Biceps Tenodesis or Tenotomy in Nebraska and Iowa
Here are steps to take when preparing for proximal biceps surgery:
- Consultation and Evaluation: Your surgeon will assess the degree of biceps damage and discuss your activity level to recommend the best option.
- Preoperative Instructions: Follow guidelines on medications, fasting, and arranging transportation. Avoid blood-thinning medications unless otherwise directed.
- Set Up for Recovery: Prepare your home for easy access to items and arrange for help with household tasks during the early recovery phase.
The Surgical Procedure
Both tenodesis and tenotomy are generally outpatient procedures that last about 30-60 minutes, performed under general anesthesia or regional block. These procedures are typically performed arthroscopically.
- Incision: A small incision is made near the shoulder to access the biceps tendon.
- Tenotomy: The surgeon simply cuts the tendon, releasing it from its attachment.
- Tenodesis: The surgeon repositions and reattaches the tendon to the humerus using a small anchor or screw.
- Closure: The incision is closed with sutures, and a protective dressing is applied.
Postoperative Care and Recovery
After surgery, you can expect some soreness and swelling. Here are key steps to aid your recovery:
- Pain Management: You may receive prescription pain medications initially, followed by over-the-counter options as needed.
- Activity Restrictions: Wear a sling to support the shoulder and protect the tendon during the initial healing phase.
- Physical Therapy: Rehabilitation begins with gentle range-of-motion exercises and progresses to strengthening exercises under a therapist’s guidance.
Recovery Timeline
- Initial Healing (0-4 Weeks): Rest and protect the shoulder, performing only light activities.
- Strengthening Phase (4-12 Weeks): Physical therapy to improve range of motion and strengthen the shoulder.
- Return to Activity (3-6 Months): Depending on the type of procedure, most patients can return to normal activities within 3-6 months.
Long-Term Outcomes
Both procedures offer excellent pain relief, improved function, and satisfaction rates. Your surgeon will monitor your progress and adjust your activity plan based on your recovery and goals.
