Bicep Tenodesis Recovery?

Amy Jordan wrote:

Andy, 

I've had a biceps tenodesis on both shoulders now. Same surgeon, about six years apart (ages 33 and 39). Both times I remember being told that the healing time is pretty short (compared to other shoulder surgeries), like 3 months. But the first time it took more like 8 months before I could touch rock on a very easy route again--no way in hell I could have climbed much before that. I remember feeling really discouraged because of what I had been expecting for the recovery timeline.

Second biceps tenodesis on the other side, I felt ready to climb easy (and did) by 3 months!! It was striking how different they were despite being the same (very competent, I think) surgeon. Both shoulders healed up nicely, despite one taking way longer. Best of luck in your recovery.

Well the overwhelming comfort here is that it takes time and should be fine in the long term. Appreciate you and congrats on the 2x full recovery. Hard to stay idle i'm sure like most of us here climbing is my therapy. 

Paawan Walia wrote:

Hey Andy,

Long story short, I (36, M)tore my subscab tendon off the bone (3.1 cm full thickness tear) and subluxation of the bicep tendon back in July (decked 20 feet after a qd unclipped itself from the wall. Followed that up 2 weeks later by falling off my bike like the Gumby i am). After numerous months of Pt and rehab with little results,  I finally got insurance to approve an MRI. I had open shoulder surgery 10’days ago and here is how I’ve been doing so far : 

day of surgery was wild. Don’t remember much and pain was non existent since they had me under nerve block. The day after surgery was the worst. The nerve block wore off and I was taking pain meds every four-six hours but I don’t do well on them so spent much of the day yaking. Reduced pain meds to 3 aspirin and 1 pm Tylenol, 2 days post op and for the first week. For the last 3 days I have been doing 1 200 mg aspirin and 1 Tylenol pm. The pain now feels more like a stiffness / soreness. I’ve been to Pt once so far and they did some assisted ROM exercises. Plan on doing PT twice a week going forward. I’m wearing the sling occasionally now once my shoulder lets me know that it’s “tired.”

I started walking (in my sling) about 5 miles everyday,  two days post op. After my first Pt sesh which was 4 days ago, I’ve been doing stationary bike and stair master at the gym for an hour each day. I was also cleared to do any leg and core workouts except for squats and using cable machines I can do 1 side back, bicep, chest, tricep shoulder workouts.

So far the experience has been a lot better than I expected. I’ve been able to sleep 6.5-8 hours pretty consistently and nutrition / diet is pretty normal as well. I have good and bad days emotionally and physically but there have been more good than bad so far. Let me know if you opt in for surgery and need a recovery buddy!

Cheers,

Paawan 

Sounds good to me! How far our are you? How you feeling? I’m 15 weeks post op. Mobility is pretty much fully back. Strength is at like 70%. Pain at to about the same level/little higher than pre surgery. 

Andy K wrote:

Sounds good to me! How far our are you? How you feeling? I’m 15 weeks post op. Mobility is pretty much fully back. Strength is at like 70%. Pain at to about the same level/little higher than pre surgery. 

Hey Andy. Glad your doing well.

I’m about 5 weeks post op. I’m in Pt twice week and just started band work. I’ve been out of the sling since week 2 and the only discomfort / pain (if I can even call it that) is when I sleep and I toss and turn but I finally slept for over 8 hours last night. I’ve been running and working out the right side of my body / core and legs since week 1 and it’s really helped. My rom of motion is getting better I still have a lot of capaulitus. I’m hoping I get cleared or start weights on that side in 4 weeks.

Quick update. I am now just shy of 8 months post biceps tenodesis surgery + in person physical therapy 3 times a week for over 6 months. My pain is still worse than it was before the surgery. After escalating my concerns with the surgeon they have officially taken the position that surgery has failed. Something to keep in mind if you're considering this surgery and you do not have any other rotator cuff (labrum) issues is to try a cortisone injection in the bicep tendon to see if it gives relief. If it does not the surgery will likely not give relief and potentially make things worse. In my situation, my surgeon did do a bicep tendon cortisone injection that did not give relief but still did the surgery afterward. Since surgery, I've learned that this was negligent on his part. All that said I'm still holding onto the long-shot hope that something suddenly improves over the next 4 months (1 year mark). If anyone is considering surgery and reads this i would be more than happy to talk about your options with you. Hindsight is 20-20 but given an opportunity to not do this surgery I would have avoided and taken an approach of more PT and time to let the body naturally heal. If anyone on here reads this and has promising insight for me through their experience that points to this still have a chance for me send it my way! :)

Andy K wrote:

Quick update. I am now just shy of 8 months post biceps tenodesis surgery + in person physical therapy 3 times a week for over 6 months. My pain is still worse than it was before the surgery. After escalating my concerns with the surgeon they have officially taken the position that surgery has failed. Something to keep in mind if you're considering this surgery and you do not have any other rotator cuff (labrum) issues is to try a cortisone injection in the bicep tendon to see if it gives relief. If it does not the surgery will likely not give relief and potentially make things worse. In my situation, my surgeon did do a bicep tendon cortisone injection that did not give relief but still did the surgery afterward. Since surgery, I've learned that this was negligent on his part. All that said I'm still holding onto the long-shot hope that something suddenly improves over the next 4 months (1 year mark). If anyone is considering surgery and reads this i would be more than happy to talk about your options with you. Hindsight is 20-20 but given an opportunity to not do this surgery I would have avoided and taken an approach of more PT and time to let the body naturally heal. If anyone on here reads this and has promising insight for me through their experience that points to this still have a chance for me send it my way! :)

I'm so sorry you're going through this.
How do you decide though whether to have surgery or not, and what kind of surgery? I'm only 4 months past accident and ORIF and I still can't lift my arm past 90 degrees unless I manipulate around on my shoulder. This has not changed at all, and my mobility is 100%, and has been at 100% for 3 months now. I also take stronger painkillers every day just to get throught the day. I can't drive car properly (automatics aren't really a thing here), I can't work on a desk. And this is my dominant arm and I have a computer job. I do start to think I also have rotator cuff problems. It would help if a doctor would investigate this properly instead of guessing. What is this cortisone injection I keep hearing about? It doesn't seem to be a thing in this country.

Andy K, that is really rough! I’m sorry to hear it. Hope there is a solution…

Andy K, that’s horrible! So sorry to hear what you’re going through.

On the flip side, I’m 7 weeks out of a shredded labrum repair, a biceps tenodesis, and a carpel tunnel release.

I tore my labrum and kept working and climbing on it, until I knew I had to stop. I took a few weeks off and then did pt for 6 weeks. One night it got way worse and it felt like someone was stabbing me with a searing hot drywall saw, and every time I moved they were twisting and pulling it.

What happened was the labrum swelled and the fluid went behind it. This fluid dried up and created a cyst that was compressing the nerve that controls my rotator cuff. Not only would my rotator cuff not function probably, but it was extremely painful.

The only hope of recovery was surgery to remove the cyst. The Dr told me because of how shredded the labrum was and my age, he recommended a slap repair, tenodesis, and upsold me on a carpel tunnel to just get everything done at once.

The first few days post op were pretty rough. The nerve block was horrible and wouldn’t do that again. I felt much better after that wore off.

I only took pain meds for 3 days and was sleeping in my bed day 2. I started doing rom stuff basically immediately, and have been progressing nicely.

Within a week or so I was in less resting pain than pre surgery due to the nerve pain being gone. I was out of the sling after 3 weeks and could lift my arm straight over my head at 4 weeks. That’s when I started PT.

I’ve just been doing isometrics, and ROM stuff, and doing some core and some floor pulls for finger strength

At 7 weeks I’m probably at 80% ROM and probably around the same strength as I was pre surgery. Honestly the carpel tunnel release recovery  has been more painful than the shoulder stuff.

I just started doing some band stuff, and was able to do some planks today.

For my case (so far) I believe I made the right call, but we’ll see how it progresses.

Voodoo floss

Tina Orbitolina wrote:

I'm so sorry you're going through this.
How do you decide though whether to have surgery or not, and what kind of surgery? I'm only 4 months past accident and ORIF and I still can't lift my arm past 90 degrees unless I manipulate around on my shoulder. This has not changed at all, and my mobility is 100%, and has been at 100% for 3 months now. I also take stronger painkillers every day just to get throught the day. I can't drive car properly (automatics aren't really a thing here), I can't work on a desk. And this is my dominant arm and I have a computer job. I do start to think I also have rotator cuff problems. It would help if a doctor would investigate this properly instead of guessing. What is this cortisone injection I keep hearing about? It doesn't seem to be a thing in this country.

Have you had an MRI or cortisone injection yet?

Posting to add insight and follow-along! I injured my Right arm twice climbing - both times falling into an undercling.

04/2009 (Age 26) - Full Distal Biceps Tendon Rupture & Repair: 2 Months Full Immobilization, Back to climbing in 5 Month, back to Full Strength in 8 Months.

11/10/2023 (Age 40) - Complete Rupture of Proximal Long-head Biceps Tendon with distal retraction of the tendon stump. Biceps Tenodesis at Steadman Clinic (Dr. Thomas Hackett)

2x Nerve Block (Shoulder & Pec), Numb arm & hand for 2x Days.  Currently on Day 5. No pain meds needed after day 3. Pain is very minimal 1-2/10, Full Passive ROM. Backpain from sleeping in a strange position is by far the worst part. Sling is "optional" - don't feel a need for it aside from social awareness/impact mitigation in public settings. Hoping to make the start of the winter Ski Guiding Season soon, and Ice Climbing work is TBD... Will update as things progress.

Update 20240628: 7 Months Post-Op, seemingly back to normal.

I tore the long head of my left bicep (dominant side), trying to be somebody while doing hang-cleans (improper catch). Many months later, and a second opinion, the long head of my bicep was repaired via tenodesis. Definitely worth getting done, and the recovery and bounce back were quicker than I expected. It's disheartening when it happens, but now it feels like such a short time that impacted my climbing. I got surgery on July 11th was TR by the end of August and led some more mellow stuff by the end of September. I would say the full range of motion and strength was there by the end of NOV. The tear happened when I was 29, surgery at 30.

I'll update that I'm 9 months out now, and started climbing again around 4 months and sent 5.12 again after 7 months post op. I feel like I'm still not 100% but getting closer. I have been battling biceps tendonitis in both arms (work related) for the last month or two, and I think I probably should have eased back into thing a bit more gradually, as the Dr told me I had no restrictions after 6 months, but I probably should've been a little slower with ramping thing back up in terms of work and play. 42 at time of surgery

How are your shoulders doing? I am 22 months out and have accepted that surgery has given my chronic pain for life. No longer able to climb. Outside of the pain my arm feels weird. The bicep on the shoulder surgery side constantly feels and, harder, and rounder than the non surgery side. For those who have had this surgery do you have the same?

So sorry to hear.

I'm 16 months out now. 

I battled really bad biceps tendonitis form about months 8-14 and had to basically shut down climbing, and take weeks off of work to try and recover. I'm mostly over it now but still have to be really careful as I can flare it up pretty easily. I have started climbing again and just sent my first 12 since the tendonitis started and am starting to feel somewhat like myself again. 

I have found that I need to keep the volume really low though. I've been taking at least two rest days and really only climbing 1-2 times a week to feel like I'm not digging myself a hole. I seems like my body is adapting slowly and I'm starting to recover faster as my body is getting more fit and adjusting to the load. It could just be that I'm getting older (43 now)

But overall I still think the surgery was the right call

That's great so happy it's going well for you. Does your bicep on your surgery arm feel different? Tighter and rounder?

Andy K wrote:

That's great so happy it's going well for you. Does your bicep on your surgery arm feel different? Tighter and rounder?

No, not at all. Mine feels the same on both sides.

Lena chita wrote:

No, not at all. Mine feels the same on both sides.

Mine is definitely "rounder", but not nearly as bad as the Popeye Arm that is once was.  As far as "firmness" goes, mine is about the same. Infact it took a few months to get it to firm back up.

Andy K wrote:

That's great so happy it's going well for you. Does your bicep on your surgery arm feel different? Tighter and rounder?

No, They feel the same

Figure I’d chime in with my own experience since I read through this thread numerous times in the lead up to my bicep tenodesis surgery.

Early Nov. 2024 got and MRI that suggested labral tearing, partial subscap tears (rotator cuff), and pretty bad biceps tendon tendinitis. At that point my pain was bad enough I could only climb “ladder” style basic climbing (had been doing PT for 1.5 yrs since a subluxation event that triggered this all). Got surgery scheduled for Dec. 2.

Dec. 2 comes around, get my surgery, and get the great news that although I had a SLAP tear, the labrum itself wasn’t tearing, but rather the bicep tendon tore at the labrum connection point. Surgeon fixed this by biceps tenodesis, and cleaned up the rest of the glenohumeral joint.

Now just over 3 months out. I’ve been extremely diligent with PT and listening to my body, making sure not to overdo it. Started easy climbing 2 weeks ago, making sure I only use downpulls, or keep arm straight on side pulls. I climb ~1-2 times a week, for short sessions 1hr at most. Ramped up the angle to 15° ish overhang last week and that felt great.

Still prioritizing PT and strengthening sessions but I feel confident in 2 months I’ll be feeling pretty comfortable on the wall if I continue to take it easy. Figure I’d share my experience as I’ve had a positive outcome, and I read through many negative experiences pre-surgery that had me very nervous.