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Distal Biceps Tendon Repair Rehabilitation Protocol

Distal Biceps Tendon Repair Rehabilitation Protocol-Brigham and Women's Hospital

Phase I: Initial Post-Operative Immobilization (Days 0-7)

  • Elbow is immobilized in brace selected by surgeon

Phase II: Mobility Phase (Weeks 2-8)

ROM Exercises Progression

  • Weeks 2-3: Passive elbow flexion and supination w/ elbow at 90°, assisted ROM for elbow extension and pronation w/ elbow at 90°, shoulder mobility as needed
  • Weeks 3-4: AAROM elbow flexion, continue assisted extension and progress to passive extension ROM
  • Week 4: AROM elbow flexion and extension
  • Weeks 6-8: Continue program as above, begin combined motions at elbow (eg extension w/ pronation)

 Strengthening Exercises Progression

  • Week 1: Sub-maximal pain-free triceps and shoulder isometrics
  • Week 2: Sub-maximal pain-free biceps isometrics w/ forearm in neutral
  • Weeks 3-4: Single plane active ROM of elbow flexion, extension, supination, and pronation
  • Week 8: Progressive resisted exercise program for all elbow motions 

Resources

1. Distal Bicep Tendon Repair-Rehabilitation Protocol. Brigham and Women's Hospital Web site. http://www.brighamandwomens.org/Patients_Visitors/pcs/rehabilitationservices/Physical%20Therapy%20Standards%20of%20Care%20and%20Protocols/Elbow%20-%20Distal%20biceps%20repair%20protocol.pdf