Biceps Tenodesis

UCLA Department of Orthopaedic Surgery - Sports Medicine · Thomas Kremen MD

Weight-Bearing

N/A (upper extremity)

Key Restrictions

Sling x 4 wks; no active ROM on land Phase I; avoid supination in grip exercises Phase I; PROM elevation to 140°, ER to 40° at 0°/45°/90°; no biceps strengthening until wk 8; wean sling wks 4-8; full ROM target by 12 wks

Timeline & Phases

Phase 1 (0-4 wks): sling, PROM: elevation 140°, ER 40° at 0°/45°/90°, IR thumb to L1, aquatic therapy 3-4 wks, grip exercises (AVOID supination), no active ROM on land | Phase 2 (4-8 wks): wean sling, PROM → full ROM all directions, aquatic therapy progressing, isometric RC ER/IR (NO biceps strengthening until wk 8), rhythmic stabilization, AAROM → AROM elevation, PNF, periscapular strengthening | Phase 3 (8-12 wks): full ROM target by 12 wks, AROM elevation/scaption in standing, light resistance theraband/dumbbells, biceps strengthening (flexion + supination) begins, aquatic therapy with paddle/webbed gloves, UBE | Phase 4 (12-16 wks): progress strengthening with weight, gym machines, isokinetics IR/ER 120-240°/sec | Phase 5 (16-24 wks): sport-specific functional progression, interval sport programs, plyometrics with pitchback, advanced strengthening

Notes

AVOID supination in grip exercises Phase I to protect tenodesis; no active ROM on land Phase I (aquatic only); no biceps strengthening until wk 8; PROM begins at 140° elevation (more permissive than labral repair which starts at 90°); biceps strengthening (flexion + supination) begins Phase 3 wks 8-12; full ROM target by 12 wks; RTS 16-24 wks; Kremen MD UCLA PatientPop practice site

Surgeon / Author

Thomas Kremen MD