Biceps Tenodesis
Biceps tenodesis is a procedure that detaches the long head of the biceps tendon from its origin at the shoulder socket (the superior labrum) and reattaches it to the upper arm bone (humerus). It is performed to treat a chronically painful or damaged biceps tendon — most commonly in conjunction with rotator cuff repair, but also as a standalone procedure for isolated biceps tendinopathy or SLAP tears that have not responded to conservative treatment.
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Who Needs Biceps Tenodesis?
Biceps tenodesis is recommended for patients with confirmed biceps tendon pathology — including partial tears, SLAP tears, and tendinopathy — who have persistent anterior shoulder pain after at least 3-6 months of physical therapy. It is often performed at the same time as rotator cuff surgery when the biceps tendon is found to be damaged intraoperatively. Older or lower-demand patients may be offered a tenotomy (simply releasing the tendon without reattachment) as a simpler alternative, accepting a possible cosmetic "Popeye" deformity.
What to Expect
Recovery Timeline
Sling immobilization. Passive range-of-motion exercises only. No active lifting.
Active range-of-motion begins. Pendulum exercises. Physical therapy starts in earnest.
Light strengthening. Restrictions on loading the biceps still apply as the tenodesis heals.
Progressive resistance training. Most daily activities possible.
Return to full strength activity and overhead sports for most patients.
Risks & Complications
- Failure of tenodesis fixation (Popeye deformity if tendon re-ruptures)
- Persistent anterior shoulder or arm pain
- Biceps cramping (usually resolves within weeks)
- Nerve or vessel injury (rare)
- Infection
- Stiffness if sling worn too long without proper rehabilitation
Frequently Asked Questions
What is the difference between biceps tenodesis and tenotomy?
Tenotomy means the tendon is simply cut and not reattached. It is faster to recover from and works well for pain relief, but carries about a 30-50% chance of a Popeye deformity (the biceps muscle bunches up and creates a visible bulge). Tenodesis reattaches the tendon, preserving cosmesis and strength — preferred for younger, more active, or cosmetically-concerned patients.
Will I lose biceps strength after tenodesis?
Most patients do not have a meaningful loss of elbow flexion strength. Studies show a 10-20% loss of supination (rotating the palm upward) strength compared to the other arm, which most people do not notice in daily life. Strength returns to near-normal levels with proper rehabilitation.
How long does the biceps tenodesis take to heal?
The tenodesis fixation takes about 3 months to heal securely. During that time, activities that load the biceps heavily — curling, carrying heavy objects with the elbow bent — are restricted. Full recovery takes 4-6 months.
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Search surgeonsEstimated Cost
$8,000 - $20,000 as a standalone procedure (before insurance). Often bundled with rotator cuff repair. Covered by most insurance when conservative treatment has failed.
Full cost breakdownRelated Specialty
Shoulder Specialists →Other Procedures
This information is for educational purposes only. Costs are estimates and vary by location, surgeon, and insurance. Always consult a qualified healthcare provider.