Bicep & Shoulder Surgery

Located in the front of your upper arm, the biceps muscle helps you bend your elbow, rotate your arm and maintain your shoulder stability. Your biceps tendon attaches the muscle to your elbow and at two places to your shoulder. Tearing the longer of the two tendons connecting your biceps and shoulder can cause you to lose strength and mobility in your arm, and may also result in shoulder pain. Though most people can still function with a torn biceps tendon, some require surgery.

Surgeons operating on a patient (Image: xmee/iStock/Getty Images)


Partial tearing of the biceps tendon, known as fraying, may require surgery. Complete tears and SLAP tears–when the biceps tendon separates from the upper end of the shoulder socket–may also require surgery. A complete tear occurs when the tendon splits in two. Often, if you have a frayed tendon and do nothing to repair it, it may worsen until it completely tears. Tearing your biceps tendon also makes you more likely to damage other parts of your shoulder.

Surgery is not always necessary to repair a biceps tendon tear. The biceps is attached to the shoulder in two places. Though the long head of the biceps tendon may be susceptible to injury, the short head rarely tears, allowing the use of the biceps even after the long head completely tears.


A variety of symptoms may clue you in that you could have a biceps tear. Sudden, sharp pain in the upper arm, an audible pop or snap, cramping of the biceps muscle, bruising from the middle of the upper arm toward the elbow, pain, weakness or tenderness in your shoulder and elbow, difficultly turning your arm palm up or palm down or a visible bulge in the upper arm above the elbow can all be symptoms.

Surgical Treatment

Arthroscopy is often used to identify and treat tears that require surgery. If only a small portion of the tendon is damaged, shaving–called a debridement–of the torn fibers may be all that is required. More serious injuries may require biceps tenodesis–arthroscopically removing the torn tendon stump from inside the shoulder joint and attaching the remaining tendon to the humerus bone using biodegradable screws or anchors. This eliminates the sliding of the tendon and removes friction. Pain relief should be immediate and complete, according to the Cape Shoulder Institute. Complications after surgery are rare


Immediately after surgery, a sling may be required to keep your shoulder immobilized. Soon after, you will likely participate in flexibility exercises to improve the mobility of your shoulder. Shoulder-strengthening exercises will likely follow.


Injury and overuse are the two main causes for tearing your biceps tendon. A sudden impact, such as falling on an outstretched arm or lifting something too heavy, can cause a tear. Often, tears are simply the result of the tendon wearing down and fraying due to perpetually repeating the same shoulder motions. Overuse can also cause various other shoulder problems, which can put more stress on the biceps tendon, making it more susceptible to tearing.

Risk Factors

A number of factors may make you more likely to suffer a biceps tendon tear. Age; frequent heavy, overhead lifting; participation in overhead sports, such as swimming, baseball or tennis; smoking; and corticosteroid medications can all make you more likely to suffer injury.

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