There are two balancing goals in rehabilitation after distal biceps repair.
The goal is to ensure adequate healing of the tendon back to the bone while preventing stiffness in the elbow.
Because the elbow is prone to stiffness if immobilized, early range of motion is critically important.
Avoid active biceps activity until 6 weeks after surgery, and avoid strengthening the biceps until 3 months after surgery.
Work and Activity Restrictions
• 0–6 weeks: No work, no use of operative hand
• 6 weeks–3 months: No lifting or carrying greater than 5 pounds
• 3 months: Return to full duty
0–6 Weeks: Protect Repair and Maintain Elbow ROM
• Wear elbow brace locked at 90 degrees except when performing exercises
• Patient-directed passive ROM in brace for flexion and extension; limit extension to 30 degrees
• Flexion and Extension: Supine active extension, passive flexion
• Pronation and Supination: Active pronation (no passive pronation), passive supination
• Wrist and hand exercises permitted
6 Weeks–3 Months: Regain Full Elbow ROM
• Continue exercises with active and passive ROM without restriction (flexion, extension, pronation, supination)
• Encourage terminal range of motion; no extension stop needed
• Discontinue brace and sling after 6 weeks
3 Months+: Strengthen
• Continue stretching if range of motion is less than the contralateral arm
• Begin biceps strengthening exercises
