Distal Biceps Repair
Download this rehabilitation protocol (PDF)
For patients and physiotherapists.
Week 0-2
Aims:
- Pain control
- Protect the biceps repair
- Allow the wounds to heal
- Maintain overall mobility
Suggested treatment:
- Arm in plaster backslab and sling
- Pain relief
Week 2-6
Aims:
- Wean out of sling
- Aim to regain passive ROM
- Including full passive ROM by week 6
- Minimal pain
Suggested treatment:
- Gradual increase in Flexion
- 2-4wks = 60° to full flexion
- 4-6wks = 30° to full flexion
Restrictions:
- No lifting/weight bearing on repaired side
Week 6-12
Aims:
- Minimal pain
- Increased active ROM
- Wean out of sling completely
- Passive ROM should be approx. the same as the other side
Suggested treatment:
- Progress to active assisted range of motion
Restrictions:
- No heavy lifting
Week 12 and beyond
Aims:
- Protect repair
- Improve endurance/power
Suggested treatment:
- Commence isometric exercises of elbow flex/ext/ supination/pronation
- Can commence resisted bicep curls/rotation/triceps
Some General Questions
What to expect after surgery:
- Most patients will stay a night post operatively
- After you wake up, you might notice some numbness to the forearm and fingers of the operated hand. This may be secondary to local anaesthetic and will wear off over 48-72 hours.
- The next morning, you will be seen by the medical team and physiotherapists prior to your discharge
- You will be sent home with medications or a script to help with pain relief
Time in Sling:
- Generally your sling should be on at all times (except for hygiene) in the first 2 weeks
- From 2-6 weeks, you can wean out of the sling gradually using it less and less each day. You do not need to use your sling at night/sleeping
- From 6 weeks, you should not need to use your sling at all
Return to Activity
- Driving: when adequate range of motion and pain to allow safe control of the car and to react appropriately in an emergency. Both arms must be fully functional and on the wheel for this to occur. Usually dependent on time in sling.
Return to driving from 6 weeks post op - Work: desk based roles should be able to return once pain has settled – usually approximately 2 weeks after surgery. Those with more manual occupations may need specific recommendations and light duties are usually recommended
- Swimming: water based exercise is very helpful after surgery. No swimming until the wounds have healed – usually 2 weeks post operatively. Active swimming from 12 weeks
- Golf: usually requires significant rehab and time before adequate protection of the biceps repair has occurred. Usually 4 to 6 months post op
- High Risk Sports (eg racquet sports, rock climbing, football, martial arts, skiing, horse riding). These sports are dependent on ROM, control and strength. Improvement in elbow strength can be seen up to 2 years post operatively. Contact sports or those at risk of falls (skiing, horse riding) shouldn’t occur till 4-6 months post op
- Strength/Weight Training: training which loads the biceps tendon is the most risky weight resistance training for your repaired biceps tendon. Resisted biceps curls only from 12 weeks and heavy lifting/weight training only from 4-6 months. Stop if pain felt in the elbow during exercises.
Concerns or questions?
If you have any concerns post operatively, or you would like further information, please contact Mr Lau through the VBJS on 03 5752 5020 or via email at admin@vbjs.com.au
If you need urgent medical help, call 000 or go to your nearest emergency department.
Patient information
These notes have been prepared by Mr Simon Lau. They are general overviews and information aimed for use by his patients. They reflect Mr Lau’s views, opinions and recommendations. They do not constitute medical advice. The contents are provided for information and education purposes only. Please seek Mr Lau’s specific advice with any questions regarding medical conditions and treatment.