Biceps Tendon — Tenotomy / Tenodesis / Subacromial Decompression / Partial RC Debridement / Distal Clavicle Excision

Saint Louis University (SLUCare)

Weight-Bearing

N/A

Key Restrictions

Sling at all times first 3 weeks including sleep; passive elbow motion only mo 0-1; no active shoulder motion mo 0-1; no biceps strengthening mo 0-2; avoid low rep/high weight indefinitely; full return pending Dr. Kaar or Dr. Cutuk approval

Timeline & Phases

Mo 0-1: sling at all times 3 weeks including sleep, AROM neck/wrist/hand 3-5x/day, wrist 6-way, passive pendulum 3x/day, passive FF scapular plane to full/IR at side, cryotherapy 3-5x/day, no active shoulder or active elbow motion; Mo 1-2: passive/AAROM/AROM including elbow, no biceps strengthening, active scapular retractions/protractions/depression/elevation, isometric shoulder strengthening (abduction, FF, extension, IR, ER), periscapular strengthening with light weights/bands; Mo 2-3: strong periscapular strengthening, rotator cuff strengthening (bands/dumbbells) when AROM full, gentle biceps strengthening light weights/high reps, full ROM by 3 months; Mo 3-5: full ROM required, high rep/low weight shoulder and periscapular strengthening, advance biceps with light weights/high reps; Mo 5-8: advanced strengthening, no low rep/high weight indefinitely, functional training (swimming, tennis, interval throwing if thrower), gradual return to sport; return to sport: full ROM, no pain, satisfactory isokinetic test, satisfactory clinical exam

Notes

SLU Sports Medicine and Shoulder Service; diagnosis: rotator cuff tear, long head biceps tear, AC joint arthrosis; covers biceps tenotomy/tenodesis, subacromial decompression, partial RC tear debridement, distal clavicle excision; Dr. Kaar and Dr. Cutuk; avoid low rep/high weight indefinitely; 4-month protocol 2-3 visits/week