Biceps tendon surgery
Biceps tendon surgery is an operation to repair a torn or damaged biceps tendon, either at the shoulder or at the elbow.
About biceps tendon surgery
Biceps tendon surgery is performed to treat a torn or damaged tendon at the shoulder or elbow.
The biceps muscle in the upper arm is attached to the shoulder and elbow joints by tendons. The proximal biceps tendon attaches at the shoulder, and the distal biceps tendon attaches at the elbow. These tendons help bend (flex) and rotate (supinate) the forearm and play an important role in shoulder stability.
Injuries to the biceps most commonly involve the long head of the tendon at the shoulder, although both heads can be affected.
Proximal biceps tendon: Tears often occur through repeated overhead activities such as throwing or heavy resistance training.
Distal biceps tendon: Tears at the elbow typically occur when the arm is suddenly loaded with the elbow straight.
Most biceps tendon injuries require urgent specialist review to determine whether surgical repair is required or whether non-operative treatment (with rest and physiotherapy) is appropriate. Early assessment is important, as timing can significantly affect the outcome.
How is biceps tendon surgery carried out?
Biceps tendon surgery is usually performed under a general anaesthetic, meaning you will be asleep during the procedure. In many cases, an additional nerve block is used to numb the arm and improve postoperative pain control. Depending on the location and type of injury, surgery may be performed using keyhole (arthroscopic) techniques or an open approach.
Proximal biceps tendon repair
For injuries at the shoulder, the surgeon drills a small hole in the upper arm bone (proximal humerus). The end of the tendon is threaded into the hole and secured using stitches and a small fixation device called an endobutton.
Distal biceps tendon repair
For injuries near the elbow, the surgeon drills a hole through the radius bone in the forearm. A stitch is placed through the end of the tendon, which is then pulled back into position and threaded into the bone. The tendon is fixed securely using an endobutton and stitches.
The surgical incisions are closed with stitches and covered with a dressing.
After biceps tendon surgery
After surgery, your arm will be supported in a sling for two to six weeks, depending on the extent of the injury and repair.
Initial tendon healing takes around three to four months. Full recovery of strength may take up to one year.
A physiotherapist will guide your rehabilitation. Exercises begin with gentle movements and progress gradually to strengthening and mobility exercises over time.
Desk-based work may be possible within one to two weeks. Jobs involving lifting, pushing, or pulling may require three to four months or longer.
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