Distal Biceps Repair Protocol

Keys to a Successful Outcome

Brace should be worn at all times to allow the surgical elbow to heal accordingly.
No lifting with the surgical arm is allowed for at least six weeks post-op.
Avoid any excessive motions with the elbow for at least 12 weeks post-op. Cautiously begin ROM exercises at 3 weeks under the supervision of a physical therapist.

Phase	Brace	ROM	WB	Exercises
Weeks 0-3	Splint/brace worn at all times (locked at 90° degrees)	None	NWB	Gentle wrist and shoulder ROM
Weeks 3-6	Worn at all times (including exercise); removed for hygiene	Active extension to 30° degrees in brace	NWB	Continue with wrist/shoulder ROM; begin active ext to 30°;no active flex; gentle joint mobilization
Weeks 6-9	Worn at all times (including exercise); removed for hygiene	Active extension to 0° degrees in brace	PWB	Continue to maintain wrist/shoulder flexibility; begin RTC/deltoid isometrics; progress to full active ext in brace; begin light AA flexion
Weeks 9-12	None	Gentle advance ROM to tolerance	Progressive WBAT	Begin active flex/ext against gravity; advance strengthening of RTC/deltoids

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