Bicep Tendon Surgery

The biceps tendon plays a crucial role in shoulder and elbow movement. Injuries or degeneration of the biceps tendon can cause pain, weakness, and limited function. When non-surgical treatments aren’t effective, biceps tendon surgery — either a tenotomy or tenodesis — can relieve pain and restore strength.

At Iowa Ortho, our orthopedic specialists provide expert evaluation and advanced surgical options to help patients regain shoulder and arm function safely and effectively.

What is biceps tendon surgery?

Biceps tendon surgery addresses injuries to the long head of the biceps tendon, which runs from the shoulder joint down the upper arm. Two primary surgical options exist:

Tenotomy

A biceps tenotomy involves releasing the damaged tendon from its attachment in the shoulder. This procedure:

Relieves pain quickly
Is less invasive
May cause minor cosmetic changes, such as a “Popeye” deformity (a bulge in the upper arm)

Tenotomy is often recommended for older or less active patients who prioritize pain relief over cosmetic appearance or minor strength loss.

Tenodesis

A biceps tenodesis involves reattaching the tendon to the humerus (upper arm bone) after releasing it from the shoulder. This procedure:

Maintains normal arm contour and strength
Reduces the risk of “Popeye” deformity
Is preferred for younger or more active patients

Your orthopedic surgeon will help determine the best procedure based on your activity level, cosmetic concerns, and functional goals.

Benefits of biceps tendon surgery

Significant reduction or elimination of shoulder pain
Improved arm strength and function
Preservation of arm appearance (with tenodesis)
Minimally invasive options are available in many cases
Faster return to daily activities and light exercise

Who is a candidate?

Biceps tendon surgery may be recommended for patients with:

Persistent pain in the front or top of the shoulder
Weakness when lifting or rotating the arm
Tendon tears or degeneration confirmed by imaging
Failure of non-surgical treatments such as rest, therapy, or injections

The procedure

Preparation: The patient receives anesthesia, and the shoulder is positioned for optimal access.
Surgery: Small incisions are made, and the surgeon either releases the tendon (tenotomy) or reattaches it to the humerus (tenodesis). Arthroscopic techniques may be used to minimize invasiveness.
Closure and recovery: Incisions are closed, and a sling is used to protect the arm while healing begins.

Surgery typically takes 45–90 minutes, depending on the complexity of the procedure.

Recovery & rehabilitation

Recovery includes:

Immobilization: The arm is kept in a sling for 2–4 weeks
Physical therapy: Gradual range-of-motion and strengthening exercises
Return to activities: Most patients return to normal activities within 8–12 weeks, with full strength returning over several months

Following your surgeon’s rehabilitation plan is key to optimal outcomes and lasting pain relief.

Why choose Iowa Ortho for biceps tendon surgery?

Expert orthopedic surgeons specializing in shoulder and elbow procedures
Minimally invasive techniques for faster recovery and less discomfort
Personalized treatment plans tailored to your lifestyle and goals
Comprehensive post-operative rehabilitation programs