Biceps Tenodesis — (Isolated)

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

Sling 3-4 weeks (surgeon-determined); sleep in sling first 3 weeks; avoid resisted elbow flexion/forearm supination for 6 weeks; no active ER/extension/abduction for 4-6 weeks; no biceps loading until week 10; return to running/biking/Stairmaster/golf (proper kinematics) permitted after week 8

Timeline & Phases

Phase 1 (0-2 wks): sling 3-4 wks, PROM (pendulums, flex/scaption 90°, ER 40°, IR 45°), scapulothoracic AROM, scapular stabilization/isometrics, gripping; Phase 2 (3-6 wks): wean sling at surgeon discretion, PROM progressing (flex/scaption 145°, ER 50°, IR 60°), AROM supination (no resistance), scapulothoracic isometrics; Phase 3 (7-12 wks): full AROM, resisted IR/ER at 30-90° abd, cautious biceps curl/supination/pronation, prone scapular program, push-up plus, rhythmic stabilization, D1/D2; Phase 4 (12+ wks): plyometrics (bilateral then unilateral), sport/throwing progression; RTS: pain-free control with sport-specific patterns, kinematic transfer hip/core to shoulder

Notes

Sling shorter (3-4 weeks) than labral repairs; no active ER/ext/abd for 4-6 weeks; no biceps loading until week 10; running/biking/golf permitted after week 8 (not shoulder-specific); 4 phases; very similar biceps restrictions to SLAP protocol; prone scapular program begins week 6; plyometrics begin Phase 4 (12+ weeks)

Published

12/2024