Biceps tendon ruptures can be devastating in high-demand sportsmen and women.  Fortunately they usually present early for evaluation and surgery.  The timespan from injury and type of tear is important in determining the type of surgery.

If you decide on conservative treatment, it is important to know that you risk chronic activity-related pain and decreased supination strength.  You will be in a brace for 3 to 6 weeks after the surgery.  It can take up to 3 to 6 months to regain optimal strength.


Pathology of the long head of biceps can lead to severe shoulder pain.  The pathology can range from inflammation, degenerative tendonitis, chronic tendinopathy, partial tearing, acute rupture, subluxation and dislocation.  It can be associated with impingement, rotator cuff tears, labral pathology or capsular tightness.  Patients typically present with shoulder and arm pain that may be worse at night or with overhead lifting. 

 

Treatment:

Conservative treatment:

  • Activity modification
  • Rest
  • Non-steroidal anti-inflammatory drugs
  • Local Infiltration (local analgesia and celestone soluspan) into the bicipital sheath.  

 

If conservative treatment fails surgery MAY be considered.

 

Surgery:

Surgery can be either a tenotomy or tenodesis.  Multiple factors (age, activity level, body habitus, occupation, sporting activities and co-morbidities) decide the treatment. 

 

The aim of surgery is to treat your pain. 

 

You will be in a sling for 2 to 6 weeks after the surgery depending on the pathology and surgery.  The physiotherapist will see you before and after the operation to optimise your rehabilitation.