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Rehabilitation Following Open/Arthroscopic
Biceps Tenodesis
Precautions: No heavy object lifting overhead
No jerking movements
Do not use affected shoulder in sitting or rising
No isolated biceps for 8 weeks
I. Immediate Motion Phase (0-2 weeks)
Goals: Re-establish non-painful ROM
Retard muscular atrophy
Re-establish dynamic stabilization
Decrease pain/inflammation
Week One
Range of Motion:
• Pendulums
• Rope and pulley (non-painful arc of motion)
• L-bar exercises (Elevation in scapular plane and ER/IR beginning at 30
degrees abduction and progressing to 45 degrees abduction
Strengthening exercises:
• Isometrics-flexion, abduction, ER, IR
• Rhythmic stabilization exercises (ER/IR and extension)
Decrease pain/inflammation:
• Ice, NSAIDS,modalities
Week Two
• Continue all Rom exercises
• May initiate heat prior to exercise
• Initiate ER/IR with L-bar at 45 degrees abduction
• Progress elevation to ~145 flexion
• Progress isometrics
• Initiate ER/IR tubing at 0 degrees abduction
II. Immediate Phase (Week 3-6)
Goals: Regain and improve muscular strength
Normalize arthrokinematics
Improve neuromuscular control of the shoulder complex
Diminish pain
Criteria to progress to Phase II:
Full ROM
Minimal pain and tenderness
Good MMT or IR, ER, flexion
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Week 3-4:
Exercises:
• Initiate isotonic program (no weight)
• Shoulder elevation
• Prone rowing
• Prone horizontal abduction
• Sidelying ER
• Shoulder abduction to 90 degrees
• Shoulder extension to neutral
• After one week, provided patient has no pain and proper form, initiate exercise with 1 pound
weight
• Normalize arthrokinematics of shoulder complex
Continue L-bar ROM
• Elevation in scapular plane
• ER/IR at 90 degrees abduction
• Joint mobilization: Inferior, posterior and anterior glides
Decrease pain and inflammation:
• Continue use of modalities, ice as needed
• May use heat prior to exercise program
Week 4-5: Progress to fundamental shoulder exercise program
III. Dynamic Strengthening Phase (Week 6-12)
Goals: Improve strength/power/endurance
Improve neuromuscular control
Prepare athlete to return to sport
Criteria to progress to Phase III
Full non-painful TOM
No pain or tenderness
Strength 70% compared to contralateral side
Week 6-8
Exercises:
• Continue isotonic program – fundamental shoulder
• Progress strengthening exercises
• Continue neuromuscular control exercises for scapular muscles
• Continue endurance exercises
Week 10-12
• Continue all exercises
• Initiate plyometric activities (2 hand chest pass, side to side throws, soccer throws) (wk 12)
• Initiate isolated biceps isometrics (week 8)
• Initiate light biceps curls (couple weights) (week 10-12)
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All Rights Reserved. Any redistribution, alteration, or reproduction of any materials herein is strictly prohibited.
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IV. Return to Activity Phase (14-22)
Goals: Progressively increase activities to prepare for full functional return
Criteria to progress to Phase IV
Full ROM
No pain or tenderness
Satisfactory muscular strength
Satisfactory clinical exam
Exercises:
• Continue ROM and strengthening program
• Continue self capsular stretches as needed
• Continue fundamental shoulder exercise program
• Initiate biceps isotonics
• Initiate one hand plyometric drills (wall dribbles, baseball throws, shovel throws)
• Continue or initiate interval sports program
• Gradually return to overhead activities i.e. sports
Copyright © by the Advanced Continuing Education Institute, LLC. AdvancedCEU.com.
All Rights Reserved. Any redistribution, alteration, or reproduction of any materials herein is strictly prohibited.
