A surgical procedure to reattach the biceps tendon to the bone to relieve pain and restore function.
The procedure is usually performed arthroscopically. The damaged or unstable portion of the biceps tendon is released from its attachment near the shoulder socket and reattached, or tenodesed, to a new position on the humerus using an anchor. The operation generally takes one to two hours and is typically day surgery.
Assessment includes examination and imaging, usually an MRI or ultrasound, to confirm the biceps tendon is the source of symptoms, since anterior shoulder pain can also arise from other structures. Standard preoperative preparation applies, including fasting and arranging transport home.
A sling is worn in the initial weeks to protect the tenodesis. Pain is managed with simple analgesia, and physiotherapy begins once the surgeon confirms healing is progressing well. Full recovery, including return to overhead sport, generally takes several months.
Early rehabilitation focuses on gentle, passive movement to protect the healing tenodesis, progressing to active exercises and then strengthening as the tendon becomes more secure in its new position. The pace of progression is guided by the surgeon and physiotherapist rather than a fixed timeline.
Risks include infection, stiffness and the general risks of anaesthesia. Specific to this procedure, the tenodesis can occasionally fail to heal fully, and some patients notice a mild change in the contour of the biceps muscle, sometimes referred to as a Popeye deformity, which is generally a cosmetic rather than functional issue.
The goal is relief of anterior shoulder pain and a biceps tendon that functions well in its new position. Most patients experience good pain relief and return to their usual activities, with strength continuing to improve over the months following surgery.
Biceps tenodesis relocates the irritated or unstable long head of the biceps tendon away from its original groove, aiming to relieve anterior shoulder pain. Most patients experience good relief of symptoms, with a structured rehabilitation programme supporting the return to normal shoulder use.
