Shoulder / Bicep Tendon Repair

The shoulder is a ball-and-socket joint made up of three bones: the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone).

Tendons help attach muscles to bones. The biceps muscle has two tendons, one of which attaches it to the bone in the shoulder and the other attaches at the elbow. The biceps help in bending your elbow, rotational movement of the forearm, and help stabilize the shoulder joint.

If a tear occurs at the biceps tendon at the shoulder, you will experience pain in the shoulder area but most people can still function and only need simple treatments to alleviate the symptoms.

However, surgery to repair the torn tendon may be required if symptoms cannot be relieved by nonsurgical treatments. Once a biceps tendon is torn, it cannot regrow back to the bone and heal by itself.

Biceps tendon tears can become either a partial tear or complete tear. A partial tear is when the tendon has not been fully severed. A complete tear includes the tendon splitting into two complete sections. In most cases, a damaged tendon will slowly begin fraying, and as the injury worsens, the tendon may completely tear when put under stress, such as lifting a heavy object. The two most common causes for biceps tendon tears include injury and overuse.

Symptoms

Some of the symptoms of a damaged shoulder or bicep tendon include pain in the upper arm, audible popping sound, bruising, tenderness, or a bulge in the upper arm area above the elbow.

Nonsurgical Treatment

Most people can recover without surgery from a shoulder or bicep tendon tear. The pain from a biceps tendon tear can resolve itself over time and minor arm weakness may never bother the patient. Some of the recommended therapies to help your shoulder or bicep tendon tear heal include rest, ice, nonsteroidal anti-inflammatory medications like ibuprofen, and even frequent physical therapy exercises to help increase flexibility, strengthen the shoulder, and help restore movement.

Surgical Treatment

Surgical treatment for a biceps tendon tear is rarely needed. For the patients that continue to experience pain and excessive weakness in their arm, surgery may be the only option. Surgery can be the best option for people who need their arm to hold under daily stress, such as athletes. Surgery may also be the best option for patients with partial tears whose symptoms are not getting better with nonsurgical treatment.

There are minimally invasive surgical procedures that provide the option of repairing the tendon with minimal incisions. The surgeon will use an arthroscopic camera and tools to re-anchor the torn tendon back to the bone. Successful surgery can return the arm's strength and function to normal.

There are several procedures to accomplish reattachment of the biceps tendon to the forearm bone. Some techniques require the tendon to be reattached using stitches passed through holes drilled in the bone, and other times a small metal implant may be used to reattach the tendon.

A biceps tendon repair requires the surgeon to make a small incision over the upper forearm. The torn biceps tendon is brought up through the incision. Two suture anchors for the tendon will be inserted into the bone. The sutures from the suture anchors are passed through the tendon in an interlocking manner to ensure a strong tendon repair.

After the repair is complete, an elbow sling / brace will be use to keep the elbow bent at 90 degrees. The brace will be removed after 4-6 weeks and it may take up to 6-12 months to regain full strength.

It is important to keep the shoulder immobilized after surgery, and slowly begin therapeutic and rehabilitation exercises to build back the strength into the shoulder area. Although it is a slow recovery, physical therapy is vital in order for the patient to develop the original strength back into the shoulder / elbow and return to strenuous activities.