The long head of the biceps tendon runs from the upper rim of the shoulder socket, through the shoulder joint, and down the front of the upper arm. When it becomes inflamed, partly torn or unstable, it can cause pain at the front of the shoulder.
Biceps tenodesis is an operation in which the painful part of the tendon is released from inside the shoulder joint and the tendon is fixed lower down on the upper arm bone. It is often done together with treatment of other shoulder problems, such as a rotator cuff tear or a SLAP tear.
At PMG Hospital, Gota, biceps tenodesis is performed using shoulder arthroscopy (keyhole surgery). This page explains biceps tendon problems, symptoms, tenotomy and tenodesis, the procedure, recovery, risks and cost factors.
The Long Head of the Biceps Tendon
The biceps muscle at the front of the upper arm has two tendons at the shoulder. The long head of the biceps tendon starts at the upper rim of the shoulder socket, near the labrum, passes through the shoulder joint and runs down a groove at the front of the upper arm bone. Because of this path, it can be affected by inflammation (tendinitis), wear, partial tearing or slipping out of its groove (instability), often together with a rotator cuff or SLAP tear.
A sudden rupture of the biceps tendon at the elbow is a different injury, which usually needs early assessment and repair.
Related pages: Rotator cuff repair·SLAP tear·Arthroscopy
Symptoms of a Biceps Tendon Problem
- Pain at the front of the shoulder and the upper arm, often worse at night
- Pain when lifting, carrying or turning the forearm, such as when turning a doorknob
- Cramping or aching in the biceps muscle after use
- Clicking or catching at the front of the shoulder, when the tendon slips in its groove
- A bulge in the upper arm (a "Popeye" sign), if the tendon ruptures completely
Assessment Before Treatment
A biceps tenodesis doctor in Ahmedabad - an orthopaedic surgeon - assesses the shoulder before advising treatment:
- 1History and examination: pain, tenderness over the biceps groove, special tests of the biceps tendon, and examination of the rotator cuff and labrum
- 2X-rays: to check the bones
- 3MRI or ultrasound: to show the biceps tendon and any rotator cuff or labral tear
- 4Diagnostic injection: in some cases, an injection into the tendon sheath helps to confirm that the pain comes from the biceps tendon
Biceps Tendon Treatment in Ahmedabad
Treatment Without Surgery
Many biceps tendon problems improve with rest from aggravating activities, physiotherapy, pain-relief medicines used as advised by a doctor and, in selected patients, a steroid injection. A biceps tenodesis treatment hospital in Ahmedabad should provide these non-surgical treatments as well as surgery.
When Surgery May Be Advised
- Pain at the front of the shoulder that continues despite proper non-surgical treatment
- Partial tearing or significant wear of the tendon
- Instability of the tendon, where it slips out of its groove
- A SLAP tear in selected patients, especially those over about 35 to 40 years of age, in whom biceps tenodesis is often preferred to SLAP repair
- A damaged biceps tendon found during rotator cuff repair or other shoulder surgery
Biceps Tenotomy vs Tenodesis
| Biceps tenotomy | Biceps tenodesis | |
|---|---|---|
| What is done | The tendon is released from inside the shoulder and is not reattached | The tendon is released and fixed lower down on the upper arm bone |
| Bulge in the upper arm ("Popeye" sign) | More common | Less common |
| Cramping of the biceps | More common | Less common |
| Recovery | Simpler and quicker | Protection of the fixation for several weeks |
| Usually considered for | Older or less active people | Younger, active people, and people concerned about the appearance of the arm |
Both procedures usually relieve pain. The choice depends on age, activity level, the appearance of the arm and other shoulder problems, and the surgeon explains which suits the patient.
Biceps Tenodesis Surgery in Ahmedabad: Step by Step
The main steps are similar in any biceps tenodesis surgery hospital in Ahmedabad:
- 1Anaesthesia: usually general anaesthesia, often with a nerve block in the neck that numbs the shoulder and arm for pain relief after surgery
- 2Arthroscopy: the shoulder joint is inspected with a camera, and other problems, such as a rotator cuff tear, are treated if needed
- 3Release: the long head of the biceps tendon is released from its attachment inside the joint
- 4Fixation: the tendon is fixed to the upper arm bone with an anchor, screw or button, either high in its groove (suprapectoral), usually arthroscopically, or lower down, below the tendon of the chest muscle (subpectoral), through a small cut at the front of the upper arm
- 5Closure: the cuts are closed and the arm is placed in a sling
Recovery After Biceps Tenodesis
| Time | What usually happens |
|---|---|
| First few weeks | Arm in a sling; gentle movement of the shoulder, elbow and hand as advised |
| About 6–8 weeks | Most daily activities |
| About 6–12 weeks | Heavy lifting with the biceps avoided; strengthening begins gradually |
| About 3–4 months | Heavy work or sport |
When biceps tenodesis is done together with a rotator cuff repair, recovery follows the longer rotator cuff repair programme.
Risks and Possible Complications
Biceps tenodesis is a common operation, but no surgery is without risk. The surgeon explains these risks before taking consent.
- Infection of the wound or inside the joint, which is uncommon but may need further treatment
- Stiffness of the shoulder, which usually improves with physiotherapy but sometimes needs further treatment
- Injury to nerves or blood vessels, which is rare
- Blood clots in the veins of the arm or leg, or in the lungs, which are uncommon after shoulder surgery
- Anaesthesia-related and general medical risks, including temporary numbness of the arm after a nerve block; the nerve block in the neck can also weaken the breathing muscle on that side for some hours, so tell the anaesthetist if you have lung disease
- Problems with the anchors, screws or other implants, which are rare
- Failure of the fixation, which may cause a bulge in the upper arm or cramping
- Continuing pain at the front of the shoulder or upper arm, or weakness, in some patients
- Fracture of the upper arm bone at the fixation site, which is rare
Biceps Tenodesis Surgery Hospital in Ahmedabad
When choosing a biceps tenodesis hospital in Ahmedabad, check that the treating surgeon is a qualified orthopaedic surgeon with valid medical council registration, that the hospital regularly performs this operation, how infection is prevented, which implants and tests are available, what physiotherapy and follow-up are provided, and what the written estimate includes.
Look beyond general phrases such as "a biceps tenodesis hospital with modern facilities" and ask which facilities are actually available on site.
Biceps Tenodesis Surgery Cost in Ahmedabad
- The fixation implant used
- Arthroscopic fixation or fixation through a small open cut
- Any other procedures, such as rotator cuff or SLAP treatment, done at the same time
- The type of anaesthesia
- Length of hospital stay and room category
- Physiotherapy and follow-up
A written, itemised estimate can be requested from the hospital after assessment.
Insurance
- Medically necessary biceps tenodesis is generally covered under health insurance policies, subject to policy terms, waiting periods and insurer approval
- Some policies have limits on room rent or implant costs; check these with your insurer before surgery
- Ask the hospital whether cashless treatment is available with your insurer, and which documents are needed
Biceps Tenodesis Doctor in Ahmedabad
Biceps tendon problems at the shoulder are assessed and treated by an orthopaedic surgeon, usually one who performs shoulder arthroscopy. A family physician may see the shoulder pain first, but the decision about tenodesis is made by the orthopaedic surgeon after examination and scans. Different professionals are involved at different stages:
| Doctor or therapist | Role in biceps tendon care |
|---|---|
| Family physician | First examination of shoulder pain; refers to an orthopaedic surgeon when pain continues or a tendon problem is suspected |
| Orthopaedic surgeon (shoulder arthroscopy) | Examines the biceps tendon, rotator cuff and labrum, advises non-surgical treatment, tenotomy or tenodesis, and performs the operation |
| Radiologist | Performs and reports the X-rays, MRI or ultrasound, and may give an ultrasound-guided injection |
| Anaesthetist | Checks fitness for surgery and gives general anaesthesia and the nerve block for pain relief |
| Physiotherapist | Guides shoulder and elbow exercises before and after surgery, and the gradual return to lifting |
Biceps Tenodesis Surgery Doctor in Ahmedabad
Before agreeing to the operation, it is reasonable to ask your biceps tenodesis surgery doctor in Ahmedabad a few clear questions about your own shoulder. The answers help you understand the plan and give informed consent.
- Is my pain coming from the biceps tendon alone, or also from the rotator cuff or labrum, and how was this confirmed?
- Have I had enough physiotherapy and other non-surgical treatment, or is surgery needed now?
- For my age, work and activity level, would a tenotomy or a tenodesis suit me better?
- Will any other shoulder problem be treated during the same operation?
- Where will the tendon be fixed, and which implant will be used?
- How long will I wear a sling, and when can I drive, lift and return to work?
- What are the main risks in my case, such as stiffness or failure of the fixation?
- Whom should I contact after discharge if I have fever, increasing pain or numbness in the hand?
Biceps Tenodesis Hospital in Ahmedabad
Biceps tenodesis is often combined with other shoulder procedures, so the hospital should be equipped for shoulder arthroscopy as a whole, from diagnosis to rehabilitation. These are the facilities that matter most:
| Facility | Why it matters |
|---|---|
| Orthopaedic OPD and X-ray | Examination and first imaging of the shoulder |
| Access to MRI or ultrasound | Shows the biceps tendon and any rotator cuff or labral tear |
| Operation theatre for shoulder arthroscopy, with infection-control practices | Infection after shoulder surgery is uncommon but serious |
| Arthroscopy equipment and fixation implants | Needed to fix the tendon with an anchor, screw or button |
| Anaesthesia services, including nerve blocks | General anaesthesia and pain relief after shoulder surgery |
| Physiotherapy service | Guides the protected exercises and the gradual return to lifting |
The facilities available at PMG Hospital are listed further below on this page.
Treating Surgeon
At PMG Hospital, biceps tenodesis is performed by:
| Detail | Information |
|---|---|
| Name | Dr. Hiren Patel |
| Qualification | MS (Ortho), B.J. Medical College, Ahmedabad |
| Specialty | Orthopaedics |
| Designation | Director & Head Joint Replacement Surgeon, PMG Hospital |
| Registration status | Registered Medical Practitioner |
| Registration number | Gujarat Medical Council Reg. No. G-20583 |
| OPD availability | Monday to Saturday, 10:00 AM - 8:00 PM |
Facilities at PMG Hospital
- Orthopaedic OPD, Monday to Saturday
- Emergency and trauma care, 24×7
- Orthopaedic physiotherapy centre
Frequently Asked Questions
When should I see a doctor about pain at the front of the shoulder?
See an orthopaedic surgeon if pain at the front of the shoulder or upper arm continues despite rest, pain-relief medicines and physiotherapy, especially with night pain, cramping or clicking. A sudden pop with a bulge in the upper arm, or sudden pain and bruising at the front of the elbow after lifting, should be assessed promptly.
What is the difference between biceps tenotomy and tenodesis?
In a tenotomy, the long head of the biceps tendon is released from its attachment inside the shoulder and is not reattached. In a tenodesis, the tendon is released and then fixed lower down on the upper arm bone. Both usually relieve pain. Tenotomy is simpler and recovery is quicker, but a bulge in the upper arm (a "Popeye" sign) and cramping are more common. Tenodesis is often preferred for younger, active people and for those who are concerned about the appearance of the arm.
Will I get a bulge in the upper arm after surgery?
A bulge in the upper arm (a "Popeye" sign) is more common after a tenotomy, because the tendon is not reattached. After a tenodesis, a bulge is less likely, although it can occur if the fixation fails.
Is biceps tenodesis usually done on its own?
Often not. Problems of the long head of the biceps tendon commonly occur together with rotator cuff tears, SLAP tears or other shoulder problems, and the tenodesis is then done in the same operation as the other treatment.
Is biceps tenodesis done by keyhole surgery?
The shoulder is inspected arthroscopically, and the tendon is released through small cuts. The tendon is then fixed to the upper arm bone either arthroscopically or through a small cut at the front of the upper arm, depending on the technique.
How long does recovery take after biceps tenodesis?
A sling is usually worn for a few weeks, and heavy lifting with the biceps is avoided for about six to twelve weeks while the tendon heals to the bone. Most people return to daily activities within about six to eight weeks and to heavy work or sport after about three to four months. When a rotator cuff repair is done at the same time, recovery follows the longer rotator cuff repair programme.
What facilities should a hospital have for biceps tenodesis?
It should have an operation theatre suitable for shoulder arthroscopy with strict infection-control practices, arthroscopy equipment, the fixation implants needed, anaesthesia services including nerve blocks, access to MRI or ultrasound, and a physiotherapy service.
What decides the cost of biceps tenodesis?
The cost depends on the fixation implant used, whether the procedure is done arthroscopically or through a small open cut, any other procedures such as rotator cuff or SLAP treatment done at the same time, the type of anaesthesia, the length of hospital stay, room category and physiotherapy. A written, itemised estimate can be requested from the hospital after assessment.
Contact and Location
PMG Hospital
3rd Floor, Athena Avenue, B/H Jaguar Showroom, Nr. Eulogia Inn Hotel, Gota, Ahmedabad, India
- Phone / WhatsApp:
- +91 96627 70141
- OPD:
- Mon – Sat · 10:00 AM – 8:00 PM
- Emergency and trauma care:
- 24×7