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Biceps Tenodesis Rehab Protocol
Keys to a Successful Outcome
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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.
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Most failures occur from excessive load placed on the tenodesis repair site. Do not lift too much, too early
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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 0-2 | 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 2-4 | Worn for comfort only | AAROM->AROM | NWB | Gentle, full AAROM in FF/Ext/Sup/Pro; Prog to AROM as tolerated; Begin sub-maximal shoulder isometrics |
Weeks 4-6 | None | Full AROM | NWB | AAROM>>AROM for Sh Abd/Ext/ER; IR/ER with Theraband; ball squeeze, avoid long-lever FF |
Weeks 6-10 | 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 10-16 | 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
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