Biceps Tenodesis

Phase I (Weeks 0-4)

1. Sling immobilization to be worn at all times except for showering and rehab under guidance of PT
2. Range of Motion –PROM -> AAROM -> AROM of elbow as tolerated without resistance (allows biceps tendon to heal into new insertion on the humerus without being stressed), AROM of shoulder (no restriction)Goals: full passive flexion/extension at elbow and full shoulder AROMEncourage pronation/supination without resistanceGrip strengthening
3. Goals: full passive flexion/extension at elbow and full shoulder AROM
4. Encourage pronation/supination without resistance
5. Grip strengthening
6. Heat/Ice before and after PT sessions 

Phase II (Weeks 4-12)

1. Discontinue sling immobilization
2. Range of MotionBegin AROM of elbow with passive stretching at end ranges to maintain/increase elbow/biceps flexibility
3. Begin AROM of elbow with passive stretching at end ranges to maintain/increase elbow/biceps flexibility
4. Therapeutic ExerciseBegin light isometrics with arm at side for rotator cuff and deltoid – can advance to bands as toleratedBegin light resistive biceps strengthening at 8 weeks
5. Begin light isometrics with arm at side for rotator cuff and deltoid – can advance to bands as tolerated
6. Begin light resistive biceps strengthening at 8 weeks
7. Modalities per PT discretion

 Phase III (Months 3-6)

1. Range of Motion – Progress to full AROM of elbow without discomfort
2. Therapeutic ExerciseContinue and progress with Phase II exercisesBegin UE ergometerBegin sport-specific rehabilitationReturn to throwing at 3 monthsThrowing from a mound at 4.5 monthsReturn to sports at 6 months if approvedModalities per PT discretion
3. Continue and progress with Phase II exercises
4. Begin UE ergometer
5. Begin sport-specific rehabilitation
6. Return to throwing at 3 months
7. Throwing from a mound at 4.5 months
8. Return to sports at 6 months if approved
9. Modalities per PT discretion