Houston Orthopedic Surgeon for Knee Injury or Shoulder Injury

Biceps Tenodesis Rehab Protocol


Dr. Lintner
Matt Holland, PT and Nathan Hironymous, PT

PHASE I (WEEKS 1-2)

Control pain, swelling, and loads placed on healing tissue.

GOALS: No increase pain and swelling, protect healing tissue, restore full PROM, and initiate scapular strengthening.

Sling should be worn for 2 weeks or until instructed to remove by Dr. Lintner. No resisted biceps for at least 6 weeks.
ROM:

  • Initiate PROM of shoulder in all planes, elbow flexion and extension, and forearm supination and pronation immediately
  • Pendulums

STRENGTH:

  • Sub-maximal shoulder isometric in all planes
  • Scapular retractions
  • Shoulder shrugs
  • Rhythmic stabilization- supine

MODALITIES: Hot pack may be used prior to treatment and cold packs can be used after treatment to control pain and swelling
TENS or IFC may be used for pain control

PHASE II (WEEKS 2- 6)

Initiate AAROM and AROM, control loads placed on healing tissue

GOALS: Increase active ROM, activity tolerance, and muscular endurance

ROM:

  • Continue PROM and pendulums
  • Initiate AAROM of shoulder
    • Pulleys into flexion and scaption
    • Supine cane into Flexion and ER
  • AROM of elbow flexion and extension
  • AROM of forearm supination and pronation
  • May initiate posterior and inferior mobilizations

STRENGTH:

  • Initiate UBE with no Resistance forward only.
  • Bicep Curls with no resistance for 6 weeks
  • Prone rows- caution should be taken not to load biceps
  • Resisted scapular retractions with T-Band
  • Standing flexion and scaption
  • Prone extension
  • Side-Lying ER
  • ER with T-band
  • Side-Lying flexion
  • Supine serratus punches
  • Triceps
  • At 4 weeks initiate IR walkouts with T-band

MODALITIES: Continue hot packs, cold packs and TENS or IFC

PHASE III (WEEKS 6-12)

Progress Rotator Cuff and Scapular Stabilizers; Initiate Biceps Strengthening

GOALS: Increase Muscular Strength and Endurance

ROM:

  • Normal AROM by week 8
  • Continue with all previous ROM activities as needed

STRENGTH:

  • UBE forward and backward
  • May continue bicep curls progressively add resistance
  • Initiate resisted wrist supination and pronation
  • Resisted IR with T-band
  • Prone T, Y, and W
  • Shoulder extension with T-band
  • PNF D2 flexion and extension with tubing
  • ER in plane of scapula
  • Side-lying ER with deceleration
  • Rhythmic stabilization with Bodyblade
  • At week 10 may begin 2 handed plyotoss- chest pass and diagonals

MODALITIES: Cold pack as needed

RETURN TO SPORT: WEEK 12

Initiate interval return to sport program

GOALS: Improve muscular strength and power, complete interval return to sport program, and return to previous level of activity/sport.

  • Continue with all strengthening exercises, increasing resistance as tolerated
  • May initiate one-handed plyotoss
  • Deceleration overhead tosses
  • Interval return to sport program when instructed by Dr. Lintner


Dr. David Lintner - Houston Orthopedic Surgeon