Biceps Tenodesis Rehab Protocol

Keys to a Successful Outcome

  • Full shoulder active range of motion can begin as early as deemed appropriate by the therapist and should be included in the general therapy program.

  • Most failures occur from excessive load placed on the tenodesis repair site. Do not lift too much, too early

  • The repair site is relatively superficial in the front of the shoulder, and ice is quite effective at decreasing pain and swelling after surgery and activity.

Phase
Brace
Elbow ROM
WB
Exercises
Weeks 0-3
Worn for the first week only*; can be worn for comfort after that
PROM/AAROM
NWB
PROM of elbow flex and sup, pro; AAROM for elbow ext
Weeks 3-6
Worn for comfort only
AROM as tolerated without pain
NWB
Begin sub-maximal shoulder isometrics for IR/ER/Abd/Add; Gentle, full AAROM in FF/Ext/Sup/Pro
Weeks 6-8
None
Full AROM
NWB
AAROM>>AROM for Sh Abd/Ext/ER; IR/ER with Theraband; ball squeeze, avoid long-lever FF
Weeks 8-12
None
Full AROM
Gentle progressive WBAT
FF/Hor Abd in prone; Ext, D1/D2 diagonals in standing; low wt/high vol ex in IR/ER @ 90°Abd; NO swimming, throwing or sports.**
Weeks 12-16
None
Full AROM
WBAT
RTC ex @ 90° of Abd; begin more functional activities; can begin inertial, plyometrics, and rapid Theraband drills***
Weeks 16+
None
Full AROM
WBAT
Progress to higher velocity movements and COD movements that replicate sport-specific patterns; Initiate overhead sports RTP program.

 

* to be worn day and night

** All exercises and activities to remain non-provocative and low to medium velocity

*** Progress gradually into provocative exercises by beginning with low velocity, known movement patterns