UKH

I have had pain in my shoulder on and off for about nine months.  After quite a lot of misdiagnosis I saw a shoulder specialist who is confident I have a damaged long head of biceps tendon. I am having a further scan to confirm but he is talking about either biceps tenotomy or tenodesis. He said that the only reason for tenodesis is to avoid popeye arm, and that there is no downside to tenotomy in terms of function and strength.

Looking back through the forums tenodesis seems more prevalent and other web searches seem to say that for active people tenodesis is preferred.

li’m mid-fifties  male, otherwise healthy, climb a few times a week (even with current pain), weirdly have generally got a bit stronger while this has gone on- third option was live with pain.

Would really appreciate any thoughts.

In reply to helix:

I have been managing a biceps tendon issue for quite a while with advice from a good physio. Like you, on and off and I have kept climbing. Now you have a proper diagnosis, are you sure you want to dive straight in to any sort of surgery without first trying conservative treatment? 

In reply to helix:

I fully ruptured my long head tendon a year and a half ago.  My doc said he more commonly removed them (for exactly the sort of issue you describe) rather than re-attach.  Regardless, he was on board with re-attaching (I did a quick google, and that'd be the tenodesis option) and I had the surgery exactly one month after the rupture with fantastic results.

I'm very glad I did, and my results have been very good indeed.  If you have any other questions I'll be happy to answer, or try to find my notes from the time.

I have been ' refused' surgery for this because the surgeon said that with my active life style is just wreak it again.

Both shoulders are affected.  Physio isn't really helping .......

In reply to helix:

No medical knowledge but have some very recent experience of ruptured long head bicep tendon:

1) Me (age 56, sport climbing into high 7s).  Full rupture of long head bicep tendon in July.  Had about 3 weeks off while getting it diagnosed and going to a physio with climbing expertise.  Operation not recommended and was given go ahead to climb, maybe not going full in on hard projecting straight away.  Within a 2 or 3 of weeks I was climbing pretty much without thinking about it, got some decent routes in the mid 7s done and then had a good trip to Chulilla where I was climbing very close to what i had been on a trip early in the year.  I honestly don't feel there's been any impact on climbing, just a not particularly  obvious popeye on my arm (my biceps being pretty weedy 😄).

2) in one of those weird coincidences my regular climbing partner (56, sport climbing low 8s) ruptured his second long head bicep tendon (other done years ago) a few weeks after mine.  His expensive private surgeon was even more positive on the outcome, said he could climb straight away and should expect little or no impact on strength.  He had been suffering from some shoulder pain prior the injury, particularly on the crux undercut move of his long term 8b project - on coming back he definitely felt better and managed to tick it early Autumn. With bigger muscles than me the popeye effect is significantly more noticeable, otherwise absolutely no impact on his climbing.

In reply to Ian Patterson:

Thanks all for the responses- a good variety of feedback!

In reply to helix:

If i remember right they grade the damage. Grade 1, frayed. Grade 3 full rupture. Both of mine are frayed and you don't get an op. on grade 1. All they can do is smooth it down.

Both mine happened late 50's and i climbed my best just before lock down (7b on sight ) Now mid 60's hmm, not amazing. I need to be  careful. 

In reply to helix: ruptured mine in a fall in 2012 (right arm, right handed). Due to other more serious injuries, it was missed until later at an out-patients app with surgeon. Surgery scheduled but was too late to re-attach, just removed remainder of tendon instead. I have a popeye bicep, difficult to get a ‘pump’ if weight training, but as surgeon said, it hasn’t held me back. E1 on Grit, 6c sport, odd 7a indoors.56 yrs old, good health. It just looks a bit uneven but I’m used to that now. HTH