Biceps tenodesis

Rehabilitation programme following biceps tenodesis, balancing early shoulder protection with progressive elbow and shoulder mobility.

Typical timeframe: Return to sport from ~4 – 6 months

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Phase 01 · Weeks 0 – 6

0 – 6 weeks after surgery

Wear sling when walking or travelling.
Otherwise remove sling with arm supported on a chair, table or pillow; the hand can be used for eating, computer and paperwork etc.
Begin passive motion 0 – 90° forward flexion supine.
3 times a day, wrist and hand exercises with a squeeze ball, but the arm must be kept internally rotated during these exercises.
With the wounds covered by a waterproof dressing, shower with the arm resting in triangular sling or supported on the shower soap dish.
Physiotherapy to teach isometric muscle contraction of deltoid and scapular stabilizers, elbow and hand movement.

Phase 02 · Weeks 6 – 12

6 – 12 weeks after surgery

Gentle elbow full extension and flexion.
No more sling, except if in a rowdy crowd situation.
Continue passive forward elevation 0 – 180°.
External rotation from internal to 0°.
Patient may walk for exercise.
No overhead abduction until all other movements are full and comfortable — premature abduction whilst the shoulder is stiff (including abnormal scapulo-thoracic rhythm) can result in impingement.

Phase 03 · Weeks 12 – 16

Work on internal and external rotation passive range of movement.
Begin formal strengthening of forward elevation, internal and external rotation; retraining of scapulo-thoracic rhythm and proprioception.
Jog and swim (breaststroke only).

Phase 04 · Weeks 16 – 24

Continue strengthening and stretching of the shoulder.
Sports specific strength and endurance training (tennis overhead serve, freestyle swimming, surfing) when fully rehabilitated with respect to motion, strength and proprioception.
This usually does not occur until 4 months — 4 – 6 months for throwing.

Last reviewed: 2025-10-15.