REHABILITATION GUIDELINES FOR DISTAL BICEP REPAIR
Phase 1- Protection Phase (Weeks 0-8) Weeks 0-2
- Immobilization for 2 weeks
- Pendulum exercises Ice
- Ice and pain modalities
- Hand gripping exercises
- Submaximal Isometric
- Triceps
- shoulder rotators
Weeks 2-4
- Increase extension in brace 10 deg per week for full extension by week 8; no strengthening
- Passive Pronation to neutral only/Full Supination
- Active ROM elbow flexion
- Gentle Passive elbow extension
- Wrist strengthening
- Grip Strengthening
- Core
- Postural Exercises
Weeks 4-8
- Submaximal isometric progressing to isotonic biceps exercises (neutral grip)
- Triceps isotonic to 10° from Max extension
- Gentle (pain-free) passive ROM Sup/Pron
- Pulleys
- UBE for AAROM
- Rhythmic Stabilization Flex/Ext & Sup/Pron
- Isometric Sup/Pron
Phase 2- Intermediate Phase (Weeks 8-12)
- Submaximal isotonic Sup/Pron
- Progression to strengthening with the shoulder in adduction
- Joint mobilizations
- Restoration of full range of motion (12 weeks)
- Strengthening of upper body musculature with neutral grip
- Biceps curls three ways (Sup/Neutral/Pron)
- Use of Dumbbells may be better than barbell
Phase 3- Advanced Strengthening Phase (Weeks >12)
- Strengthening of Sup/Pron (hammer, golf club, pole)
- Move to strengthening with supinated grip
- Closed chain exercises
- PNF resistance patterns
- Isokinetics
- Plyometrics
- Return to sport at 4 months (Earliest)