The majority of pain complaints about the shoulder relate to a person feeling pain in the front and sometimes towards the front and side of the shoulder. This is true whether the problem is from a torn rotator cuff tendon, bursitis, tendinitis or rupture of the biceps tendon, or advanced arthritic decay of the shoulder. Figuring out the cause of the pain and designing a solution for that is sometimes difficult. In the last 10 to 15 years undue attention has been given to the biceps tendon. Overwhelmingly, non-arthritis-related shoulder pain has been found to be the result of impingement of the overlying acromion bone, or prominent arthritic AC joint. Over the past 47 years since popularized by Charles Neer, MD. Surgical removal of bone creating more space and eliminating “impingement’ reliably eliminates the pain in over 90% of the patients so treated. Without substantiation some surgeons have sought to solve this pain by cutting the biceps tendon (tenotomy) or cutting it and anchoring it into the upper humerus bone (tenodesis).
The majority of people undergoing a biceps tendon procedure are also treated with trimming of the acromion (acromioplasty) which in itself normally would solve the problem. Biceps tenotomy results in a “Popeye muscle” in a lean or muscular person and a substantial residual number of patients continue to complain of some degree of discomfort. Tenodesis prolongs recovery dramatically plus adding substantially to the cost. An acromioplasty results in limited down time, quick recovery, and overwhelming excellent results- without biceps tenodesis or tenotomy.
In summary, beware of the doctor offering or performing a biceps tenotomy or tenodesis without strong photo proven intraoperative confirmation of the abnormality.