Shoulder rehabilitation guidelines for biceps tenodesis orthoindy. Physical therapy standards of care brigham and womens hospital. Surgical treatment for a biceps tendon tear of the shoulder is rarely needed. Arthroscopic labral repair protocol, ii, iv, and complex tears. Shoulder rehabilitation guidelines for biceps tenodesis. Rehabilitation guidelines for biceps tenodesis the shoulder has two primary joints. Rehabilitation guidelines for biceps tenodesis with soft.
No resisted shoulder abductionflexion or elbow flexionsupination x 6 wks. Biceps tenotomyprocedure the long head of biceps tendon is released from its attachment in the shoulder joint, allowing it to fall down into the upper arm and out. Biceps tenodesistenotomydcesadpartial cuff debridement. Bicep tenodesis protocol weeks 12 full time in sling to minimize biceps activity and avoid shoulder extension at night when supine. Biceps curl begin with concomitant biceps tenodesis tenotomy motor control internal and external rotation in scaption and flex 90125 rhythmic stabilization irer and flex 90125 rhythmic stabilization. The glenoid labrum is a ring of cartilage that turns the.
Postoperative rotator cuff repair rehabilitation protocol. Biceps tenodesis protocol boston shoulder institute. Rehabilitation guidelines for biceps tenodesis with soft tissue fixation the shoulder has two primary joints. Physical therapy standards of care brigham and womens.
May need physical therapy supervision for functional training. Biceps tenodesis rehabilitation please give to your physiotherapist 0 to 6 weeks see dr burrow in his rooms at 2 weeks postop begin passive motion 0 90 forward flexion supine with the elbow bent to 90 gentle passive er to 20 and ir elbow gentle flexion to full extension in neutral rotation or supination. No isolated biceps activation with elbow flexion or straight arm resisted. An open subpectoral biceps tenodesis is a procedure which involves removing the long head of the biceps from the glenohumeral joint and fixing it the humerus deep to the pectoralis major tendon. It is an option when pain is caused by problems with. Rotator cuff repairbiceps tenodesis mizzou sports doc. Rehabilitation following tenodesis will progress more slowly over the first 6 weeks to. Clinic appointments at 8 to 11 days, then at 6 weeks, 12 weeks, 18 weeks and possibly 24 weeks physical therapy appointment starting at 2 weeks acute phase. Begin advanced strengthening with weights, dumbbells and bands to include muscles. Postoperative instructions shoulder arthroscopy and. Biceps tenodesis rehabilitation program gundersen health system.
A biceps tenodesis is typically done when there is significant chronic long head of the biceps dysfunction either along its length or from its labral attachment. Rehabilitation is similar to that for type ii repair except for biceps activity. Microsoft word rotator cuff repairbiceps tenodesis. Postoperative rehab protocol bankart repair, slap repair or biceps tenodesis phase i. Physical therapy section bicep tenodesis revised november 2016 adapted from william beaumont army medical center postop days 1 7 sling x 6 weeks even while sleeping place pillow under shoulder arm while sleeping for comfort no resisted shoulder abductionflexion or elbow flexionsupination x 6 wks. It is no means intended to be a substitute for ones clinical decision. Consultation with the surgeon regarding the progression of. Learn about physical therapy standards of care and protocols from the rehabilitation services at brigham and womens hospital. Apply ice to the shoulder to reduce pain and swelling. Arom of elbow if biceps tenodesis performed, no resisted motion, wrist and forearm.
A biceps tenodesis is a surgical procedure performed for the treatment of a damaged proximal long head of biceps tendon. Consultation with the surgeon regarding the progression of biceps activity based on the integrity of the biceps tendon repair is required. Biceps strengthening exercises can be advanced, however, light weights and high repetitions should be emphasized. Postoperative instructions shoulder arthroscopy and rotator. The normal attachment of the long head of the biceps. If the treating physical therapist needs to learn more about biceps. Physical therapy section bicep tenodesis revised november. A biceps tenotomy is typically done when there is significant chronic long head of the biceps dysfunction or for definitive treatment of labral pathology with biceps anchor instability or for pain relief with irreparable massive rotator cuff tears. Pendulum move arm for 1 minute, do 3 repetitions 5 times a day lean forward and let operative arm dangle with muscles completely relaxed. Rehabilitation following tenodesis will progress more slowly over the first 6 weeks to protect healing biceps tendon. Bicep tenodesis rehabilitation protocol university orthopedics. Patients with additional surgery will progress at different rates. A biceps tenodesis may be performed as an isolated procedure but more often is part of a larger shoulder surgery, such as a rotator cuff repair.
This protocol was developed for patients who have had a bicep tenodesis. Subpectoral biceps tenodesis protocol the intent of this protocol is to provide the therapist with a guideline of the postoperative rehabilitation course for the patient that has undergone a subpectoral biceps tenodesis. Full time in sling to minimize biceps activity and avoid shoulder extension at night. Bicep tenodesis rehabilitation protocol this protocol was developed for patients who have had a bicep tenodesis. Typically this procedure is also performed in conjunction with another procedure, i. A biceps tenodesis procedure involves cutting of the long head of the biceps just prior to. Begin sports related rehab at 3 months, including advanced conditioning return to throwing and begin swimming at 3 months, throw from pitchers mound at 4. Biceps tenodesis is a surgical procedure used to reduce pain in the shoulder and surrounding area. A biceps tenodesis is a type of surgery used to treat a tear in the tendon that connects your biceps muscle to your shoulder. Other procedures may have been involved such as rotator cuff. You will go to the recovery room and generally will be discharged after 12 hours. If the treating physical therapist needs to learn more about biceps tenodesis and rehabilitation we recommend reading. Arthroscopic labral repair protocoltype ii, iv, and.
Lintner matt holland, pt and nathan hironymous, pt. Sling immobilization to be worn at all times except for showering and rehab under guidance of pt 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. No active elbow flexion or supination against resistance for 4 weeks. The glsm biceps tenodesis rehabilitation program is an evidencebased. Protective phase day 1 to week 6 weeks 02 shoulder sling x 6 weeks sleep in sling x 3 weeks shoulder, elbow, and hand rom o no resisted active isolated biceps activity elbow flexion or forearm supination x 6 weeks.
Biceps tenodesis protocol this rehabilitation protocol has been developed for the patient following a tenodesis reattachment of the long head of the biceps tendon surgery. Once the dressing is removed on the first or second day, ice is applied for 20minute periods 34 times per day. Stop at first resistance for external rotation for first 2 weeks o. It is an option when pain is caused by problems with the biceps tendon in the arm. Initiate manual resistance er supine in scapular plane light. If you have a biceps tenodesis, use the nonoperative arm to move your elbow. Biceps tenodesis rehabilitation boston sports medicine. Postop guidelines surgical arthroscopy of shoulder and. Subpectoral biceps tenodesis rehabilitation protocol. Achieving the criteria of each phase should be emphasized more than the approximate duration. Gently allow arm to move by rocking body side to side, forwardback and in small circles. The overall goals of the surgical procedure and rehabilitation are to.
Arthroscopic labral repair protocoltype ii, iv, and complex. One part of the shoulder blade, called the glenoid fossa forms a flat, shallow surface. This protocol will vary in length and aggressiveness depending on factors such as. Biceps tenodesis procedure technique in simple definition, this procedure aims to remove the increasing pressure of the biceps by cutting the attachment of the biceps tendon from the shoulder socket and attaching it.
Implants are available with suture eyelets or closed eyelets for surgeons who prefer a whipstitching technique. Biceps curl begin with concomitant biceps tenodesistenotomy motor control internal and external rotation in scaption and flex 90125 rhythmic stabilization irer and flex 90125 rhythmic stabilization quadruped alternating isometrics and ball stabilization on wall. Sling immobilization to be worn at all times except for showering and rehab under guidance of pt 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. Biceps minneapolis bicep tendonitis mn sports and ortho. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt.
This is coupled with the humerus shaped like a golf ball to make up the joint. Postoperative protocols in this procedure, the superior labrum and biceps anchor is reattached to the superior glenoid or upper humerus. The normal attachment of the long head of the biceps is surgically cut and reattached to the humerus with either a soft tissue or hardware fixation technique. Phase i weeks 12 control pain, swelling, and loads placed on healing tissue. The family of swivelock tenodesis implants is designed to support a multitude of proximal biceps tenodesis techniques and maximize or efficiency. Rehabilitation guidelines for biceps tenodesis uw health. However, surgery may be the right option for those with partial tears whose symptoms are not relieved with nonsurgical treatment. Educate patient on limited use of operative arm despite potential lack of or minimal pain complaints.
Forked eyelets are also available for an allarthroscopic approach. Biceps tenodesis procedure, rehab protocol and physiotherapy. Full rotator cuff and bicep strength on manual muscle testing. May 31, 2018 biceps tenodesis is a surgical procedure used to reduce pain in the shoulder and surrounding area. Biceps tenodesis procedure technique in simple definition, this procedure aims to remove the increasing pressure of the biceps by cutting the attachment of the biceps tendon from the shoulder socket and attaching it to the long bone of the arm humerus. Slap type ii repairbiceps tenodesistenotomy protocol. Bankart slap and biceps tenodesis rehabilitation protocol. The primary aims of any rehabilitation protocol for biceps tendon tenodesis are firstly, to get the tendon healed, and secondly, to maintain shoulder motion and. Biceps tenodesis rehabilitation preoperative instructions within one month before surgery as indicated preoperative office visit for history and physical examination and instructions complete blood count cbc electrocardiogram ekg if over the age of 50 within several days before surgery wash the shoulder and axilla well.
Surgical arthroscopy of shoulder and open biceps tenodesis. No increase pain and swelling, protect healing tissue, restore full prom, and initiate scapular strengthening. Rehabilitation after subacromial decompression and biceps. Timeframes for active and resisted biceps activity will vary depending on the extent of bicipital involvement.
Early passive range of motion is highly beneficial to enhance circulation within the joint to promote healing. The tenodesis may be performed alone or as part of a larger procedure. As rehabilitation after subacromial decompression and biceps tenodesis dr keith holt the primary aims of any rehabilitation protocol for biceps tendon tenodesis are firstly, to get the tendon healed, and secondly, to maintain shoulder motion and rotator cuff strength. While the postop dressing is in place, icing should be done continuously. Biceps tenodesis clinical practice guideline background indications for tenodesis include partial tears 25%, tendon subluxation, recalcitrant tendinopathy, chronic tendon atrophy, and impingement, slap, or rotator cuff treatment. Biceps tenodesis is a minimally invasive surgical procedure used to repair a rupture or partial tear of the biceps tendon. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course for a patient that has undergone a subpectoral biceps tenodesis. If the treating physical therapist needs to learn more about biceps tenotomy and rehabilitation we recommend reading. This rehabilitation protocol has been developed for the patient following a tenodesis reattachment of the long head of the biceps tendon surgery.
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