Distal Biceps Repair Rehabilitation Protocol

Post-operative Rehabilitation for Osteochondral Defects Requiring Microfracture, and Removal of Loose Bodies Without Extensive Capsular Release

The goals of rehabilitation are to primarily maintain range of motion, reduce swelling and pain, strength maintenance and return to functional activity as able.

 

Phase 1: Day 0 – 14

Goals

  • Reduce swelling and pain, gentle range of motion, maintain wrist and shoulder range of motion

Action

  • Sling

  • Ice, gentle compression first 72 hours.

  • Wrist and shoulder range of motion exercises

    • Extension of the shoulder strictly with a flexed elbow.

  • Gentle range of motion of the elbow (assisted) avoiding the final 20 degrees extension

  • Active and passive gentle pronation and supination in 90 degrees of elbow flexion

  • No loading of the hand and elbow

  • Gentle grip exercises

  • Swelling reduction

 

Phase 2: Day 14 – week 8

Goals

  • Improve range of motion, gentle strengthening

Action

  • Achieve full range of motion of the shoulder and elbow including pronation supination in flexion and extension

  • Gentle strength active loading up to half kilogram (500g)

  • All exercises should be pain free and not induce swelling

Phase 3: Week 8 – 12

Goals

  • Maintain elbow range of motion. Strengthening and endurance

Action

  • Gradual increase in strength active up to 5 kgs

  • All exercises should be pain free and not induce swelling 

Phase 4: From week 12 onwards

Goals

  • Return to sport and normal functional activity

Action

  • Loaded training including concentric and eccentric strength work

    • Increase endurance

    • Increase strength

  • 6 – 9 months to return to sporting and full loading activity based on physiotherapy assessment of equivalent strength to contralateral arm.

    • Explosive activities as the final phase of rehabilitation.