Part of the biceps muscle at the shoulder can be a source of pain. This is called the long head of the biceps. This structure starts inside the joint and makes its way out of the main shoulder joint (the glenohumeral joint) to the upper arm. It provides little function apart from maintaining tension in the muscle belly and positional feedback in the joint but can cause a lot of pain. It might be called the “appendix” of the shoulder in that, while it is not a necessary structure, it can be quite troublesome.
The biceps tendon can frequently be the source of pain, a sensation of instability and mechanical symptoms. Occasionally this tendon can rupture. This does not need early surgical treatment but may cause a cosmetic change in the shape of the muscle. If symptoms such as fatigue pain persist or where high demand loading required for work or sport is affected, surgery may be necessary downstream.
Like many shoulder conditions the pain from the biceps can often be managed with injections and physiotherapy. The level at which the problem arises determines which type of injection and what physio is required. Where the problem is resistant then surgery may be necessary and can mean simply cutting the biceps(tenotomy), repairing its origin (Labral/SLAP repair) or transferring the effected affected segment of the tendon outside the joint(tenodesis). I can discuss these options and their implications with you during your consultation.
A short period of immobilisation with physiotherapy over 3-6 months is typically required. Return to sport is dependent on the type of surgery and the patient demand.
I can discuss the options and the usual recovery with you at your consultation.
Physios: see our therapy guidelines for post-operative care