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Biceps Tenosynovitis and Biceps Tears

The biceps is a tendon that connects from your shoulder to your elbow and helps elevate your shoulder and arm in addition to flexing your elbow.  As it exits your shoulder, it runs in the bicipital groove between the subscapularis and supraspinatus of the rotator cuff.  Biceps tenosynovitis is an inflammation of the tendon that can cause pain, weakness, or snapping within the shoulder.  The biceps tendon can be partially torn or even fully detach at the shoulder, causing a "popeye" deformity, which looks like the muscle drops down in the arm and appears larger.  The pain associated with a biceps tear frequently lessens with time, and much of the weakness associated with biceps dysfunction can be attributed to the rotator cuff.  50% of people with a biceps tear will have a rotator cuff tear as well.  You may ultimately require surgery for your rotator cuff instead of or in addition to your biceps tear.

Nonoperative Treatment of the Biceps Tendon

Tenosynovitis and biceps tears can frequently be made to feel better with activity modification, rest, ice, anti-inflammatory medications, and physical therapy.  Some people will additionally benefit from a cortisone injection into the bicipital groove or subacromial space.

Arthroscopic Biceps Tenodesis and Arthroscopic Biceps Tenotomy

Some people will remain symptomatic after nonoperative care or others will be unwilling to accept the cosmetic deformity or loss of strength.  Arthroscopic biceps tenodesis repairs the healthy portion of the biceps tendon to the humerus, or arm bone.  This can be done independently, or in addition to arthroscopic rotator cuff repair.  Arthroscopic Biceps Tenotomy is a surgery to release the tendon from its attachment on the glenoid, or shoulder blade, and is reserved for a select group of patients. 

Arthroscopic Biceps Tenodesis Video