Rehabilitation after Distal Biceps Tendon Repair

Distal Biceps Tendon Repair or Reconstruction

Indications: 

  • Acute (within 3 weeks) traumatic distal biceps rupture
  • Chronic distal biceps tendon rupture

 

Protocol Acute Repairs (within 3 weeks of Injury)

Post Operation

Day 1 - 2 weeks

  • Pain free active flexion and extension within limits of sling
  • Full supination and pronation
  • Full active shoulder movement with elbow flexion maintained

2 weeks

  • Active ROM in all directions, to point of mild stretch. No overpressure.

6 weeks 

  • Continue with Active ROM
  • Introduce light resistance <2kg through full ROM
  • Gradually increase resistance keeping progress pain free with easy and good quality movement

12 weeks

  • Biceps strengthening

 

Protocol Chronic Injury Repairs

Day 1 - 2 weeks

  • Pain free active flexion and extension within limits of sling
  • Full supination and pronation
  • Full active shoulder movement with elbow flexion maintained

2 weeks

  • Active ROM in all directions, to point of mild stretch. No overpressure

12 weeks 

  • Begin loading starting from <2kg and follow the above guideline as for acute repairs

 

** DO NOT USE THERABAND IN REHAB PROGRAM **

 


Milestones;

Acute Repairs

6 weeks 

  • Full ROM flexion / extension / supination / pronation
  • Pain free, Driving, Working

12 weeks 

  • >90% strength in comparison to opposite side flexion/Supination

 

Warning:  Avoid sudden loading and unplanned movements for 6 weeks for both acute and chronic repairs

 

Chronic Repairs

6 weeks 

  • Pain free 50-70% extension of ROM to other side
  • Full ROM flexion / supination / pronation

12 weeks  

  • <15 lag extension (80% of extension)
  • Full ROM flexion / extension / supination / pronation, Pain free, Driving, Working

6 months 

  • 80-90% Extension with full ROM in all other directions
  • 80-90% flexion strength to contra-lateral side
  • 70% supination strength to contra-lateral side

Warning:  Avoid sudden loading and unplanned movements for 6 weeks for both acute and chronic repairs

 

Return to functional activities

Return to work

  • Sedentary job: as tolerated
  • Manual job:     12 weeks

Driving

  • 6 - 8 weeks

Swimming

  • Breaststroke: 6 weeks 
  • Freestyle: 12 weeks

Golf

  • 12 weeks

Lifting

  • Avoid lifting heavy items for 12 weeks.

Contact/High Impact Sports (e.g. Rugby League, AFL, martial arts, racket sports and Surfing)

  • 12 weeks

 

 

 

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