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 Distal Biceps Tendon Repair Surgical Rehabilitation

Phase I (2 – 4 weeks)

Appointments

  • Home exercise program will begin after surgery – 2 weeks

  • 1-3x/wk. from 2-6 wks.

Rehabilitation Goals

  • Improve range of motion

  • Decrease pain and inflammation

  • Maintain strength/establish motor control

Precautions

  • Remain immobilized for first 2 weeks

  • Hinged elbow brace weeks 2-6

  • Avoid excessive shoulder extension

  • Avoid full elbow extension until 3 weeks

  • No forceful elbow extension

Range of Motion

Weeks 2-3
• Brace unlocked at 30 degrees to full flexion

Weeks 3-4
• Brace unlocked to full extension to full flexion

Suggested Therapeutic Exercise

Weeks 2-3

  • Passive range of motion of elbow flexion and supination (elbow at 90 degrees)

  • Assisted Range of motion for elbow extension and pronation (elbow at 90 degrees)

  • Shoulder range of motion as needed, avoid excessive extension

  • Sub maximal pain free isometrics for triceps and shoulder

    musculature

  • Submaximal pain free biceps isometrics with forearm in

    neutral Weeks 3-4

  • Initiate active assisted range of motion elbow flexion

  • Continue assisted extension and progress to passive range of

    motion

  • Single plane active range of motion elbow flexion, extension,

    supination, and pronation

Cardiovascular exercise

• Walking, stationary bike in brace

Progression Criteria

  • Full active ROM flexion and extension

  • No swelling or inflammation

 

Phase II (weeks 4-8)

Appointments

• Rehabilitation appointments are 1-3 times per week

Rehabilitation Goals

  • Improve range of motion to full

  • Maintain/improve strength

Precautions

• Avoid forceful elbow and shoulder extension

Suggested Therapeutic Exercise

Week 4

  • Active Range of motion elbow flexion and extension

  • Single plane active range of motion elbow flexion, extension,

    supination, and pronation Week 6-8

  • Continue as above

  • May begin combined/composite motions

  • If at 8 weeks postoperative the patient has significant range of

    motion deficits therapist may consider more aggressive management, after consultation with referring surgeon to regain range of motion

  • Progressive resisted exercise program is initiated for elbow flexion, extension, supination, and pronation

Cardiovascular Exercise

• Walking, biking, stair stepper and running (if cleared)

Progression criteria

  • Full range of motion

  • No pain, swelling, or inflammation

 

Phase III (weeks 8-12)

Appointments

• Rehabilitation appointments 1-3xwk

Rehabilitation Goals

  • Continue to improve strength and function

  • Return to activity as tolerated

  • Improve endurance

Precautions

• Progress gradually into proactive exercises by beginning with low velocity, known movement patterns

Suggested Therapeutic exercises

  • Continue all activities as above

  • May initiate light upper extremity weight training program

  • Initiate endurance program that stimulates desired

    work/activity requirements

Cardiovascular exercise

• Replicate sport or work specific energy demands

Progression Criteria

• Dynamic neuromuscular control with multi-plane activities without pain or swelling

 

Phase IV (Weeks 13- 24)

Appointments

• Rehabilitation appointments 1-3xwk

Rehabilitation Goals

• Return to sport/work

Precautions

• Progress gradually into sport specific demands

Suggested Therapeutic exercises

  • Continue/progress strengthening exercises

  • Activity as tolerated is permitted

  • Begin sport specific training

Cardiovascular exercise

• Replicate sport or work specific energy demands

Progression Criteria

• Dynamic neuromuscular control with multi-plane activities without pain or swelling

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