Biceps Tenodesis Physical Therapy Protocol

Rehabilitation after open biceps tenodesis focuses on protecting the tendon fixation while restoring shoulder comfort, motion, and arm function.

The long head of the biceps tendon must heal securely to bone before aggressive lifting, pulling, curling, or twisting is resumed.

Phase 1: Protection Phase — 0 to 4 Weeks

• Sling for comfort as instructed
• Hand, wrist, and elbow motion encouraged
• Passive shoulder motion as directed
• No resisted elbow flexion
• No resisted forearm supination
• No lifting, pulling, or carrying with the operative arm

Early aggressive biceps loading may stress the healing tendon fixation.

Phase 2: Motion and Early Function — 4 to 8 Weeks

• Progress active shoulder motion
• Continue shoulder mobility exercises
• Begin gentle scapular stabilization
• Gradual return to light daily activities
• Gentle biceps activation only when cleared

The goal is to restore motion without prematurely stressing the tenodesis site.

Phase 3: Strengthening — 8 to 16 Weeks

• Progressive biceps strengthening
• Rotator cuff strengthening
• Scapular strengthening
• Resistance training progression
• Gradual return to lifting and pulling activities

The goal after biceps tenodesis is restoration of shoulder comfort, arm strength, and functional use while protecting tendon healing.