Bicep Pain After Rotator Cuff Surgery : 6 Critical Causes

Shoulder pain is extremely common and can be caused by a number of things including performing typical daily activities or heavy lifting.

Whilst most ailments can be remedied with conservative treatments such as rest, ice packs and perhaps physical therapy exercises, in more extreme cases a surgical procedure is necessary.

Bicep Pain After Rotator Cuff Surgery
Rotator Cuff Diagram

Rotator cuff injuries are common and rotator cuff repair surgery is a standard procedure that can help alleviate pain and improve function in the shoulder.

Most shoulder injuries are that of a torn rotator cuff and tend to happen with repetitive movements such as with certain sports and weightlifting exercises.

Depending on the size of the tear would depend on whether or not surgery is required.

Recommended Reading – Rotator Cuff Tendinitis Exercises – Avoid These 8 Damaging Movements

Arthroscopic surgery is usually performed on tendon tears to the shoulders, this is less invasive and a type of keyhole surgery.

As with any surgical intervention, recovering from a rotator cuff injury can be challenging and complete recovery can take some time.

As a result, arm pain, stiffness and inflammation are expected after a rotator cuff surgical repair.

That said, it’s natural to wonder when these symptoms may indicate a serious problem.

You may also be curious about how long recovery usually takes and whether you should take some precautions for a speedy and full recovery.

This article will answer all these questions and more.

Is Bicep Pain After Rotator Cuff Surgery Normal?

The first few weeks after rotator cuff surgery can result in some pain and discomfort . Understanding what to expect post-op can help make the recovery process less overwhelming.

Things To Expect Post-Op

Pain Management

Pain and soreness are common symptoms following rotator cuff surgery. However, your surgeon will likely provide you with pain relief to help manage the discomfort.

Swelling and Bruising

The surgical area may be swollen and bruised for a few weeks post-op. But don’t worry; this is normal and will subside as your body heals.

Limited Mobility

The majority of patients are likely to experience limited mobility and range of motion in your shoulders up until several months post-surgery. As your arm will be in a sling, it will become stiff causing this reduction of mobility.

Physical Therapy

Physiotherapy will likely form part of your treatment plan and typically start within the first month after your surgery. Your therapist will work with you to help you regain the full range of motion, strength, and function of your shoulder.

How Long Does Recovery Take After Rotator Cuff Surgery

Typically, full recovery can take anywhere from several months to a year.

However, the recovery time frame varies from person to person and depends on several factors, including the severity of the injury (recovery time from surgery to small tears is usually less), the type of surgery performed, and the patient’s compliance with post-op rehabilitation programs.

It’s normal for recovery to take slightly longer in older patients.

Recovery from rotator cuff surgeries can be divided into two phases:

The initial 6-8 weeks of recovery focus on reducing pain and inflammation and protecting the surgery site.

During this time, patients will typically be in a sling and have limited use of the affected arm. Pain, swelling, and bruising are common and normal in this phase.

The next 4-6 months focus on regaining strength, endurance, and range of motion to the shoulder socket and surrounding tendons.

Physical therapy is a crucial part of this phase, and pain is to be expected.

What Symptoms Are Abnormal? 

Though pain is to be expected after rotator cuff surgery, certain symptoms may be a cause for concern. These include:

  • Persistent severe pain may indicate an infection or other complication.
  • Increased swelling and redness around the surgery site can be a symptom of an infection.
  • Numbness or tingling in the arm or hand can indicate nerve damage.
  • Persistent fever may result from an infection.
  • Drainage from the surgical site can be a sign of an infection.
  • Difficulty moving the arm weeks after surgery may indicate a problem with the surgery or the healing process.

If you experience any of the symptoms above, contact your surgeon or healthcare provider.

Causes Of Bicep Pain After Rotator Cuff Surgery

A rotator cuff is a group of muscles and tendons that surround the shoulder joint.

When you damage these muscles, it can lead to pain and weakness in the shoulder.

So what causes bicep pain after rotator cuff surgery?

Here are a few possible reasons.

Tearing Of The Bicep Tendon

The bicep muscle has two tendons that help move the bones; the proximal bicep tendon has an attachment point at shoulder bone, and the distal bicep tendon has an attachment point at the elbow.

During rotator cuff surgery, the proximal bicep tendon can become damaged or torn. When this happens, it can cause severe pain and weakness in the bicep muscles.

However, this is a relatively rare complication.

Nerve Damage

The rotator cuff muscles are closely connected to the nerves that run through the shoulder, including the suprascapular nerve and axillary nerve.

During surgery, these nerves can become damaged or compressed, leading to pain, weakness, or a tingling sensation in the arm and bicep.

Once again, though, this is a rare complication that occurs due to incorrect surgical procedures.

Scar Tissue

After surgery, it’s common for your body to form scar tissue around the surgical site.

Scar tissues are your body’s natural defense mechanism and help protect the affected area from infection.

However, this build up of scar tissue can put pressure on the bicep muscles, leading to pain and discomfort.

Overuse of Affected Arm

Though physical therapy is important for regaining strength and function, overusing your arm more than what your physical therapist prescribed may lead to pain and weakness. It can even set back your recovery.

Remember that for the first few days following your surgery, you shouldn’t engage your rotator cuff muscles at all, hence why you’re arm is in a sling for the first few weeks.

Even if you try to use your hand to lightly stabilize an object, you will inevitably engage your shoulder muscles.


If you return to your normal activities too soon, you may re-injure your shoulder and cause pain in the bicep.

Remember undertaking typical activities for a few weeks after surgery should be avoided. Trying to use them regardless will result in injury and may even require you to undergo surgery again.


Poor posture can put extra stress on the rotator cuff and cause pain in the bicep. This includes rounding your shoulders and hunching your back.

Poor posture puts can put extra pressure on the rotator cuff, which is already healing from surgery. Additionally, poor posture can lead to nerve compression, which further amplifies pain after rotator cuff surgery.

Recommended Reading – 7 Best Lower Trap Exercises For Posture And Improved Body Positioning

Management And Treatment Of Pain

The most effective and crucial way to manage and treat bicep pain post rotator cuff surgery is by incorporating physical therapy as part of your outpatient procedure.

Physical therapy will help you regain your range of motion, strength, and mobility in a safe and controlled manner. Your physical therapist will guide you through various exercises to restore your shoulder’s functionality.

If the pain becomes unbearable or feels out-of-the-ordinary, there are a few other things you can do to manage and treat the pain. Some of the most common treatment options include:

  • Pain medications are typically prescribed after surgery to help manage pain and discomfort. Your doctor may even prescribe anti-inflammatory medications such as ibuprofen. Always consult your doctor before taking any pain medication.
  • Applying ice or frozen gel packs to the affected area for 20-30 minutes can help reduce pain and inflammation.
  • Resting and elevating your arm above the level of your heart can help reduce pain and swelling.
  • Surgery revision may be necessary in some cases, especially if you re-injure your arm or the initial surgery had some complications.

Tips For Preventing Pain

Unfortunately, bicep pain after rotator cuff surgery is a common and unavoidable symptom.

However, there are some preventive and precautionary measures you can take to keep pain levels to a minimum. Here are some tips:

  • Follow your physical therapy plan.
  • Practice good posture by keeping your shoulders back and down and avoiding slouching.
  • Avoid any movements that cause pain.
  • Use a sling or brace to protect your arm during the early stages of recovery.
  • Don’t push your body too hard; if you feel like you need a break or rest, then take it.
  • Regularly ice your shoulders to reduce pain and inflammation.
  • Take pain medication, but only as prescribed by your doctor.

Keep in touch with your surgeon throughout the recovery process and report any unusual pain or other symptoms immediately. 


Bicep pain after rotator cuff surgery is a common concern among patients. But don’t let it discourage you, as it is a normal part of the recovery process.

Of course, persistent, and severe pain, discoloration, fever, and tingling sensations can be indicative of something else. Still, these complications are quite rare.

With the right knowledge and preventative measures, you can manage your symptoms enough for a smooth and successful recovery.

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