Distal Biceps Tendon Repair Recovery Pathway
A short, stage-by-stage guide to recovering after distal biceps tendon repair. Your recovery moves through just a few phases — this page walks you through what to expect at each one.
Was your repair acute or chronic?
An acute repair is done soon after the injury. A chronic (older or reconstructed) repair sits under more tension, so Dr. Hachadorian advances your motion more slowly. Switch this to see the pacing that applies to you — when unsure, ask the office.
The biceps attaches to your forearm bone (the radius) by a strong tendon at the front of the elbow. When that tendon tears off the bone it is reattached surgically, and it now needs time to heal back down to the bone. The goal for the first two months is simple: let the tendon heal while gently keeping the elbow from getting stiff. The two motions that stress a fresh repair most are fully straightening the elbow and forcefully turning the palm up (supination) — so we protect those early and add them back gradually.
Weeks 0–2 — In the splint
Rest and protect the repair. Control swelling and pain.
What to do
- Keep your splint on at all times — keep it clean and dry, and cover it for showers.
- Elevate your hand above heart level as much as possible for the first few days to limit swelling.
- Move the parts that aren't splinted — wiggle your fingers and move your shoulder — to stay loose and help swelling drain.
- Take your pain medications on schedule (see your Medication Organizer). Ice over the splint for comfort.
Do not
- Do not remove the splint or move your elbow.
- Do not lift, carry, push, or bear weight with the arm.
- Do not get the incision wet or apply creams/ointments unless told to.
First visit → ~Week 8 — Range-of-motion brace
Splint comes off; a hinged brace lets the elbow straighten a little more each week.
The brace has a stop that keeps your elbow from fully straightening — this protects the repair. Each week we open the brace another 10° so your arm can straighten a bit more, until it reaches full extension. Bending the elbow is generally allowed freely inside the brace from the start; it's straightening that we control.
Extension progression
| Week | Brace lets your arm straighten to | What it means |
|---|---|---|
| ~Week 2 | Stops at 60° | Bent about a third of the way; not fully straight yet |
| Week 3 | Stops at 50° | A little straighter |
| Week 4 | Stops at 40° | |
| Week 5 | Stops at 30° | |
| Week 6 | Stops at 20° | Almost straight |
| Week 7 | Stops at 10° | |
| Week 8 | Full (0°) | Arm fully straightens; begin weaning out of the brace |
Dr. Hachadorian sets your exact starting point and may adjust the schedule at each visit.
Activity during this stage
- Wear the brace at all times, including sleeping, except for showering and prescribed exercises.
- Motion is gentle and protected — avoid actively bending against resistance and forcefully turning the palm up.
- No lifting — nothing heavier than a coffee cup, and only if Dr. Hachadorian okays light use.
- Start your therapy exercises exactly as prescribed; your therapist works within the brace limits.
Weeks 8–12 — Out of the brace
Regain full, comfortable motion and begin gentle strengthening.
- Once you've reached full straightening and Dr. Hachadorian approves, you'll wean out of the brace.
- Work toward full, pain-free motion in every direction, including turning the palm fully up and down.
- Around 10–12 weeks, gentle strengthening begins — light resistance for bending, straightening, and forearm rotation, progressed as tolerated.
- Most light daily activities resume. Still no heavy lifting yet.
3–6 months — Strengthen & return
Build strength back and return to lifting, work, and sport.
- Progressive strengthening continues, gradually adding resistance and heavier lifting as strength returns.
- Heavier lifting is typically added after about 3 months, guided by Dr. Hachadorian.
- Full return to sport, heavy labor, and unrestricted lifting is usually around 4–6 months, once you have full motion, near-normal strength, and clearance.
- Your exact timeline depends on your healing and whether your repair was acute or chronic.
Do
- Wear your splint, then your brace, exactly as directed
- Keep the incision clean and dry
- Move your fingers, wrist, and shoulder
- Do prescribed exercises within the brace limits
- Take pain & constipation medications on schedule
- Elevate and ice to control swelling
Avoid
- Straightening the elbow past your brace setting
- Actively bending the elbow against resistance
- Forcefully turning the palm up (supination)
- Lifting, carrying, or pushing with the arm
- Taking the brace off outside showers/exercises
- Getting the incision wet before it's healed
Call the office right away if you have
- Fever over 101.5°F, chills, or spreading redness, warmth, or drainage from the incision
- Pain that is worsening or no longer controlled by your medication
- New numbness, tingling, or weakness in the hand, or fingers that turn pale, blue, or cold
- A sudden “pop” with new weakness or a change in the shape of your arm
- Calf pain or swelling, chest pain, or shortness of breath — call 911 for chest pain or trouble breathing
This pathway is a general educational guide for patients recovering from distal biceps tendon repair. Dr. Hachadorian may adjust it based on your specific surgery, tissue quality, and healing. Whenever his instructions differ from this page, follow Dr. Hachadorian.