Biceps Tendon Injuries & Tendonitis Treatment Options

Most often biceps tendonitis is treated with conservative management which is effective for a majority of patients. The goal is to reduce inflammation, relieve pain, and restore function without the need for invasive procedures. Key nonsurgical treatment includes:

Rest and Activity Modification

Limiting activities that aggravate the biceps tendons can help reduce strain and promote healing. Patients are advised to avoid repetitive lifting, overhead movements, and other activities that might worsen the inflammation.

Ice Therapy

Applying ice packs to the affected area several times a day can help decrease inflammation and numb the pain. This is especially beneficial in the initial stages of treatment.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Medications like ibuprofen or naproxen can reduce pain and swelling. These are typically recommended for short-term use under the guidance of a healthcare provider.

Physical Therapy

Customized physical therapy programs are essential for improving flexibility, strength, and overall shoulder health. Specific exercises focus on stretching and strengthening the muscles around the shoulder and elbow to relieve pressure on the biceps tendon. Physical therapy can also help correct any biomechanical issues that might be contributing to tendon strain.

Corticosteroid Injections

In cases where inflammation and pain persist, a corticosteroid injection may be administered directly to the inflamed area to provide relief. These injections are used cautiously, as repeated use can weaken the tendon over time.

Platelet Rich Plasma (PRP) Injections

By using a patient’s own biology, a blood draw in the office can be performed, blood spun down and the plasma componenet (no red blood cells) injected in a concentrated form to the affected area. There are growth factors to induce tissue healing and anti-inflammatory properties to help with pain.

Surgery may be necessary for patients who have not found relief from nonsurgical treatments or have more severe tendon damage or other associated shoulder conditions. Dr. Ziegler employs minimally invasive surgical techniques to assess the condition and evaluate other shoulder structures. During arthroscopy, he will make a small incision and insert a tiny camera, called an arthroscope, into your shoulder joint. The camera sends live video to a monitor, allowing your surgeon to see inside the joint and guide small surgical tools to treat the problem accurately.

Arthroscopy ensures effective results and quicker recovery.

Surgical options include:

Biceps Tenodesis

Biceps tenodesis is a surgical procedure used to treat shoulder pain caused by problems with the biceps tendon, which connects the biceps muscle to the shoulder. In this procedure, the damaged or irritated part of the tendon is removed, and the healthy part is reattached to a new spot on the upper arm bone (humerus). This helps relieve pain and improve shoulder function by removing deseased tissue and stabilizing the tendon.

Biceps Tenotomy

Biceps tenotomy involves cutting the affected portion of the biceps tendon to relieve pain. This is a quicker and less invasive option, generally suitable for older patients or those with lower physical demands. While this procedure can lead to a slight bulge in the upper arm (often referred to as a “Popeye” deformity), it effectively reduces discomfort and allows for a faster recovery with less postoperative restrictions. There is minimal to no functional deficit by cutting the tendon (tenotomy).

Arthroscopic Debridement

Arthroscopy allows Dr. Ziegler to remove any damaged or inflamed tissue around the biceps tendon. This procedure is minimally invasive and helps alleviate pain by cleaning out the affected area, providing relief without the need for more extensive surgery.

Recovery from biceps tendonitis treatment varies based on the severity of the condition and the chosen method of treatment. For nonsurgical management, the recovery period may range from a few weeks to a few months, depending on how quickly inflammation subsides and strength returns.

Postoperative Care

After surgical procedures, a brief period of immobilization is often recommended along with protected weight bearing to protect the repaired tendon. Patients are typically advised to wear a sling for a few days and recovery a few months allowing enough time to heal, regain motion and get back strength followed by a gradual return to normal activities.

Rehabilitation Programs

Dr. Ziegler emphasizes the importance of comprehensive rehabilitation to ensure full recovery. Physical therapy plays a crucial role in restoring strength, flexibility, and range of motion. A structured rehabilitation program usually includes:

• Stretching and Range of Motion Exercises: Gentle exercises to prevent stiffness and restore movement to the shoulder and arm.
• Strengthening Exercises: Gradual resistance training to rebuild the strength of the biceps and surrounding muscles, helping prevent future injuries.
• Sport-Specific Training: For athletes, sport-specific exercises are introduced to help them return to their activities safely and efficiently.

Follow-Up Care

Regular follow-up appointments with Dr. Ziegler and his team ensure that the recovery process is on track. During these visits, the treatment plan may be adjusted to address any ongoing concerns or to facilitate a quicker return to daily activities and sports.