Distal Biceps Repair — Distal Biceps Tendon Repair

Gundersen Health System (GLSM) · Gundersen Lutheran Sports Medicine

Weight-Bearing

N/A (upper extremity); no lifting or carrying on injured side Phase I

Key Restrictions

Posterior splint at 90 deg wk 0-1; hinged brace wk 1 at all times except bathing, HEP and PT, extension block 60 deg wks 1-2, 40 deg wks 2-3, 30 deg wks 3-4, 20 deg wks 4-5, 10 deg wks 5-6, 0 deg wk 6+ (flexion to 110 deg); wean brace wks 5-6 in controlled settings, D/C wk 7; no aggressive pronation stretching; active flexion only in protected mid-range Phase I; active pronation/supination at wk 4; no strengthening Phase I; no resisted isotonic elbow flexion or supination until wk 8; no heavy lifting Phase II; no maximum lifting until 6 months with MD approval

Timeline & Phases

3 phases: Phase I (0-6 wks, maximum protection, braced ROM progression, PROM/AAROM per tolerance), Phase II (6-12 wks, full ROM by wk 8, elbow isometrics wk 6, light isotonics wk 8), Phase III (12+ wks, strengthening and return to activity); full return 3-6 months

Notes

Evidence-based; Bledsoe telescoping brace; PROM may exceed brace settings per tolerance, with emphasis on regaining extension to avoid flexion contracture; low-load long-duration extension stretch from wk 4 if needed; scapular and glenohumeral strengthening per Moseley and Townsend; PT about 1x/wk Phase I, 1-2x/wk Phase II

Surgeon / Author

Gundersen Lutheran Sports Medicine

Published

March 2010