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slap or pulley lesion - tenedosis?


Jan Nitschke
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Jan Nitschke

Hey,

need some advice / experiences. had biceps tendinits since 2 years now got another mri and went to some specialist which diagnosted that i got most likely the anchor of my biceps (long head) damaged or less likely a pulley lesion. got recommend to do surgery and reattach or if not possible do tenedosis. tried conservative protocoll about 1 year, doc said my posture is quiet good and no impigment so it seems to be questionable if there is a chance to heal on conservative protocol at all. also  he said that this problem can lead to other problems like f.e my supraspinatus tendon got a bit degenerated and maybe  its not a good idea to wait longer and try to fix it without surgery

thankful for any advice / experience

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Alessandro Mainente

HI Hab, it depends if there is a labrum problem also. The pure dislocation os the long head bicep lead to a minor problem because you lose no more than the 4-5% of shoulder flexion where the primary mover are other muscles and you do not lose supination of the forearm. Conservative work can be a solution, then...it depends on the level of sports activity you need to perform.

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Jan Nitschke

thanks for your answer, well problem with this is that i went to 2 specialists, the 1st said that he thinks its a pulley lesion and the 2nd said he thinks its a damaged bicep anchor. i think the 2nd had better arguments and i also showed him the diagnosis of the other doc. i got an mri and they did several tests with me, but it seems to be not so easy to give a 100% diagnosis even with mri.

what can be done on conservative way, cause from what i know there is no chance to fix a pulley or slap lesion on conservative way it will not heal by itself especially as i got this now for 2 years and didnt get much better. or am i wrong? also both docs said that i got a good posture and no big imbalances which can better the situation alot if this would get fixed

 

so what i think now is that i have to go for surgery and hope that they can reattach the long head where it anatomicly has to be and if its pulley lesion they will do tenedosis.  they both didnt say anything about my labrum...

if this is the case question for me is what i will loose if the biceps get attached at the humerus hopefully not to much. does anybody here has experience with tenedosis? 

 

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Alessandro Mainente

What does the MRI say? it is necessary to see if labrum tear appears. usually, the torn process of the LBT (long bicep tendon) is related to a labrum tear.

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Jan Nitschke

well actually they just said its a slap lesion and maybe pulley lesion, but i will ask them again. they also didnt say which type/grade but why is that important? if there is a tear and i will not heal by itself why not go for surgery? do you have any thoughts on tenodesis as i am bit aware of this cause its chances anatomy and i am gonna ask again if they are sure that i will not loose function etc.

 

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Alessandro Mainente

The level of slap is important, sometimes shoulder pain can be managed with conservative technique, sometimes you need surgery. I think that the specialist will give you a reasonable answer, something you can't find in a forum.

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