Proximal biceps tendon repair

Surgery for a proximal biceps tendon tear fixes a tendon that is torn near the shoulder. The proximal biceps tendon connects the biceps muscle to the shoulder blade.

A biceps tendon treatment is usually done as arthroscopic surgery. Your doctor puts a lighted tube and other surgical tools through small cuts (incisions) in your shoulder. The lighted tube is called an arthroscope, or scope. Most people go home the same day of the surgery.

Your doctor may choose to do an open surgery. The doctor will make a 2- to 4-inch incision over your shoulder. If you have open surgery, you will probably stay in the hospital overnight.

In both surgeries, scars usually fade with time. The shape of your biceps should remain the same.

Your arm will be in a sling for about a month. You will need rehabilitation (rehab). This will probably start 1 to 2 weeks after your surgery and last for 2 to 3 months. It will take about 4 to 6 months for your shoulder to heal.

You may be able to do easy daily activities in 2 to 3 weeks, as long as you do not use your affected arm. Most people who work at a desk job can go back to work in 1 to 2 weeks. If you lift, push, or pull at work, you may be able to go back in 3 to 4 months. You should be able to throw objects and play sports 4 to 6 months after the surgery. How long your recovery takes depends on your injury and how well your rehab goes.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. You may be more comfortable if you sleep in a reclining chair. To make your arm and shoulder feel better, keep a pillow under your elbow while you are lying down.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• For 4 weeks, avoid lifting anything with your arm.
• Wait until your shoulder is completely healed and your doctor says it is okay before you do activities that stress your shoulder. These include chopping wood, playing contact sports or sports with risk of falls, lifting heavy weights, and doing overhead work such as painting a ceiling.
• You may drive when you are no longer taking pain medicine and feel you can control the car. This will take about 4 weeks or as your doctor says.
• If you had arthroscopic surgery, you can take a shower 48 to 72 hours after surgery. If your doctor agrees, remove the sling, and leave your arm by your side. To wash under your armpit, lean over and let the arm fall away from your body. Do not raise your arm.
• If you had open surgery, do not shower until your doctor says it is okay.
• Most people who work at desk jobs can return to work in 1 to 2 weeks. If you lift, push, or pull at work, you may be able to return in 3 to 4 months.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids, unless your doctor tells you not to.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, take an over-the-counter medicine such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
  • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you had arthroscopic surgery and have a dressing over your cut (incision), keep it clean and dry. You may remove it 2 to 3 days after the surgery.
• If you had open surgery, do not remove your dressing until you see your doctor and they okay it. Keep it clean and dry.
• If your incision is open to the air, keep the area clean and dry.
• If you have strips of tape on the incision, leave the tape on for a week or until it falls off.

Exercise

• You will need rehabilitation. This is a series of exercises you do after your surgery. Rehab helps you get back your shoulder's range of motion and strength. You will work with your doctor and physical therapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you.

Ice

• Put ice or a cold pack on your shoulder for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.