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Proximal Biceps Tendon Tear Surgery: What to Expect at Home

Location of biceps at front of upper arm, with inside view of proximal tendons attaching biceps to shoulder bone

Your Recovery

You will feel tired for several days. Your shoulder will be swollen, and you may notice that your skin is a different colour near the cut the doctor made (incision). Your hand and arm may also be swollen. This is normal and will go away in a few days. Depending on the medicine you had during the surgery, your entire arm may feel numb or like you cannot move it. This goes away in 12 to 24 hours.

You will have stitches (sutures) and a bandage on your shoulder. You may be able to take off the bandage in about 3 days, or when your doctor tells you to. Your shoulder will also be in a sling for about 4 weeks. You may take the sling off when you dress or wash and during rehabilitation (rehab). If the sutures are not the type that dissolve, your doctor will take them out 7 to 10 days after your surgery.

You will need rehab. This will probably start 1 to 2 weeks after your surgery and last for 2 to 3 months. It takes about 4 to 6 months before your shoulder heals.

You may be able to do easier daily activities in 2 to 3 weeks, as long as you do not use your affected arm. 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.

Most people can start activities with low risk of shoulder injury in about 3 months. Jogging is an example of this type of activity. If you play sports, training may also start at this time. Most baseball or softball players can begin a program to toss a ball lightly. It may take 6 to 12 months to return to normal throwing. How long it takes depends on how damaged your shoulder was and how well your rehab goes.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

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 fibre 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. He or she will also give you instructions about taking any new medicines.
If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
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 he or she okays 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 physiotherapist 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.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have severe trouble breathing.
You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor or nurse call line now or seek immediate medical care if:

Your hand is cool, pale, or numb, or it changes colour.
You are unable to move your fingers, wrist, or elbow.
You are sick to your stomach or cannot keep fluids down.
You have pain that does not get better after you take pain medicine.
You have a fever over 38°C.
You have loose stitches, or your incision comes open.
Your incision bleeds through your first dressing or is still bleeding 3 days after your surgery.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- Swollen lymph nodes in your neck, armpits, or groin.
- A fever.

Watch closely for any changes in your health, and be sure to contact your doctor or nurse call line if:

Your sling feels too tight, and you cannot loosen it.
You have new or increased swelling in your arm.
You have new pain that develops in another area of the affected limb. For example, you have pain in your hand or elbow.
You do not have a bowel movement after taking a laxative.
You do not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.