One of the challenges with many bone and joint injuries is deciding between surgery and nonsurgical treatment. Often that decision is based largely by how active the patient is and what activities he or she is trying to get back to. In this Ask Dr. Geier video, I discuss how a patient’s activity level could impact the treatment decision for a common shoulder injury, an injury of the long head of the biceps.

Sam asks:
I recently (7 days ago) tore the long head tendon of my bicep. I am a very active and competitive 52-year-old male. I saw a PA for a reputable surgeon in the area. He evaluated me and stated that surgery would not be recommended. He said that only one of the surgeons in their practice performs the re-attachment and that the tendon will re-attach itself at the humerus in time at a lower area than the shoulder where it tore. He stated that I should see 100% recovery without surgical intervention. I have had no pain but some cramping. He also said that should diminish over time. Should I be consulting with someone about potential surgery?

Injuries to the long head of the biceps tendon at the shoulder can be treated nonoperatively in older or less active patients. A bulge in the biceps muscle can persist over time. The patient might have some weakness, but for the most part they do well. More active people often undergo surgery to reattach the biceps tendon – a biceps tenodesis. In this video, I explain the different options.

Shoulder pain from a long head of the biceps injury

Also read:
Ask Dr. Geier: Shoulder pain from the biceps tendon
Ask Dr. Geier – Biceps tendon ruptures

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