50 patients with chronic biceps tendinopathy undergoing a subpectoral biceps tenodesis were randomized to receive the procedure with the elbow and forearm positioned in pronation-supination (n=25) or in a neutral position (n=25). Outcomes of interest included pain on a Visual Analog Scale (VAS), the American Shoulder and Elbow Surgeons (ASES) score, Constant scores, and flexion and supination force. Outcomes were measured up to 12 months post-operation. The results of this study found that placing the forearm in pronation-supination during the procedure significantly improved pain and functional outcomes (VAS; ASES) in the first 6 months compared to a neutral position. However, a statistically significant but clinically insignificant reduction in supination strength was observed in the pronation-supination group.