Distal Biceps Tendon Repair — Complete Exercise Program

Elbow Range of Motion

Gentle bending, straightening, and forearm turning to keep the elbow moving freely.

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tips:

• Keep the upper arm still — the movement is at the elbow and forearm.
• Sore is okay; sharp is a sign to ease back.

Commonly done as 2–3 sets of 10 each, daily.

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Scapular Retraction

Gentle shoulder-blade squeezes — safe immediately, because the shoulder joint itself does not move.

What it helps: Keeps the muscles that position the shoulder blade working while the shoulder joint itself is resting. Those muscles set the platform the whole shoulder moves on, and they weaken quickly in a sling, which makes the later recovery harder than it needs to be.

1. Sit or stand tall with your arms resting at your sides or supported in the sling.
2. Draw both shoulder blades gently back and down, as though squeezing them toward each other.
3. Keep the movement small and slow. Your arms should not move at all.
4. Hold briefly, then relax completely.

Tips:

• Small is correct. This is a squeeze between the shoulder blades, not a shrug and not an arm movement.
• Because the shoulder joint stays still, this is usually allowed from the first days — check with your care team if unsure.
• Easy to do sitting at a desk or watching television, several short sets through the day.

Commonly done as 2–3 sets of hold 5s, 10 times, daily.

Arm Nerve Glides

Gentle movements that help a neck nerve slide freely down the arm.

What it helps: Helps an irritated neck nerve glide freely down the arm, which can ease arm pain, tingling, or numbness. Gentle, repeated motion — never forced.

1. Sit or stand tall. Start with the affected arm out to the side, elbow bent, palm up.
2. Slowly straighten the elbow and ease the arm out while gently tilting your head AWAY — then return as you tilt the head back toward that side.
3. Move smoothly in and out of the range, like flossing — never holding at the end or pushing into symptoms.

Tips:

• Gentle is the rule — ease back the moment it provokes sharp or shooting arm symptoms.
• Small, smooth, repeated movements — not a hard stretch.
• Stop and check with your care team if symptoms steadily worsen.

Commonly done as 2–3 times sets of 10–15 slow glides, daily.

Wrist Isometrics

Gentle no-movement holds that calm tendon pain while keeping the muscles active.

What it helps: Loads the forearm tendons gently without movement — a comfortable way to keep them strong and often to ease tendon pain before they're ready for moving resistance.

1. Rest the forearm on a table, hand off the edge. For extensors: make a light fist, push the back of the hand up against your other hand — no movement — and hold.
2. For flexors: push the palm down against your other hand and hold.
3. Use comfortable pressure; the wrist stays still.

Tips:

• No movement happens — you're holding against resistance.
• Start light; isometrics often ease tendon pain, so find a comfortable level.

Commonly done as 1 sets of Hold 20–45 sec ×3–5, daily.

Gentle Neck Isometrics

A steady, held press against your own hand — strengthens the neck with no movement.

What it helps: Strengthens the deep muscles that support and steady your neck without moving it — a safe, comfortable way to build the support that eases neck pain.

1. Sit tall with a gentle chin-tuck. Place your palm on your forehead.
2. Press your head lightly into your hand and your hand back into your head — a steady, comfortable push with NO movement of the neck.
3. Hold, relax, and repeat. Do the same with the hand on the back of the head, then each side.

Tips:

• Light pressure — about 20–30% effort. This is not a strength test.
• No actual neck movement: the head stays still while the muscles work.
• Keep the gentle chin-tuck throughout.

Commonly done as 5 each direction sets of Hold 5–10 seconds, daily.

Core Activation

Gentle core engagement to support posture and balance while you recover.

What it helps: Switches on the deep core muscles that stabilize your pelvis and spine, giving your hips a solid platform to move from.

1. Lie or sit comfortably.
2. Gently draw your belly button toward your spine.
3. Hold a few seconds while breathing normally, then relax.

Tips:

• Avoid holding your breath.

Commonly done as 2-3 sets of 10, daily.

Walking Program

Short, frequent walks build endurance and confidence.

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Elbow Range of Motion

Gentle bending, straightening, and forearm turning to keep the elbow moving freely.

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tips:

• Keep the upper arm still — the movement is at the elbow and forearm.
• Sore is okay; sharp is a sign to ease back.

Commonly done as 2–3 sets of 10 each, daily.

Forearm Rotation

Strengthens the muscles that turn the palm up and down.

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

1. Tuck the elbow at your side, bent 90°, holding a light weight or a hammer by the handle.
2. Slowly rotate the forearm to turn the palm up, then down, through comfortable range.
3. Keep the elbow pinned to your side.

Tips:

• Holding a hammer toward the head end adds gentle resistance — slide your grip to adjust.
• Keep the elbow still; only the forearm rotates.

Commonly done as 2–3 sets of 10–12 each way, most days.

Forearm Stretch (Flexors & Extensors)

Stretches the muscles of the forearm that attach at the elbow.

What it helps: Loosens the forearm muscles that attach at the elbow — easing the tension that pulls on irritated tendons and limits comfortable wrist and grip use.

1. Straighten the arm in front of you, palm down. With the other hand, gently bend the wrist down until you feel a stretch along the top of the forearm (extensors).
2. Then turn the palm up and gently bend the wrist down to stretch the underside (flexors).
3. Hold each gently; keep the elbow straight.

Tips:

• A gentle, steady pull — never sharp.
• Keeping the elbow straight makes the stretch reach the muscles that attach there.

Commonly done as 3 sets of Hold 20–30 sec each, daily.

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Wrist Curls

Strengthens the forearm muscles in both directions.

What it helps: Builds balanced forearm strength in both directions — the everyday strength behind a comfortable, capable wrist and grip.

1. Rest the forearm on a table, hand off the edge, holding a light weight.
2. Palm up: curl the wrist up, then lower with control (flexion). Palm down: lift the back of the hand up, then lower (extension).
3. Move smoothly through comfortable range.

Tips:

• Light weight, controlled motion.
• Build the forearm in both directions for balance.

Commonly done as 2–3 sets of 12–15 each, most days.

Scapular Retraction

Gentle shoulder-blade squeezes — safe immediately, because the shoulder joint itself does not move.

What it helps: Keeps the muscles that position the shoulder blade working while the shoulder joint itself is resting. Those muscles set the platform the whole shoulder moves on, and they weaken quickly in a sling, which makes the later recovery harder than it needs to be.

1. Sit or stand tall with your arms resting at your sides or supported in the sling.
2. Draw both shoulder blades gently back and down, as though squeezing them toward each other.
3. Keep the movement small and slow. Your arms should not move at all.
4. Hold briefly, then relax completely.

Tips:

• Small is correct. This is a squeeze between the shoulder blades, not a shrug and not an arm movement.
• Because the shoulder joint stays still, this is usually allowed from the first days — check with your care team if unsure.
• Easy to do sitting at a desk or watching television, several short sets through the day.

Commonly done as 2–3 sets of hold 5s, 10 times, daily.

Shoulder Isometrics

Gentle no-movement holds that switch on the shoulder muscles without straining the joint.

What it helps: Activates and strengthens the shoulder muscles with gentle static holds — a comfortable way to build strength early, before the joint is ready for moving resistance.

1. Stand near a wall or door frame. For external rotation: elbow bent and tucked, press the back of your hand/forearm gently into the wall and hold — no movement.
2. For abduction: press the outside of your arm into the wall. For flexion: press the front of your fist into the wall.
3. Use light, comfortable pressure, hold steadily, then relax.

Tips:

• No movement happens — you're gently pressing against something solid.
• Start at about a quarter effort; never push into pain.

Commonly done as 2 sets of Hold 5–10 sec ×5, most days.

Stationary Bike

Builds motion and endurance with low impact.

What it helps: Keeps the joints moving and nourished while you build endurance — all with no pounding. One of the gentlest ways to stay active when a joint is sore.

1. Set the seat so pedaling is comfortable.
2. Pedal at an easy pace.
3. Increase your time gradually.

Commonly done as directed.

Forearm Rotation

Strengthens the muscles that turn the palm up and down.

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

1. Tuck the elbow at your side, bent 90°, holding a light weight or a hammer by the handle.
2. Slowly rotate the forearm to turn the palm up, then down, through comfortable range.
3. Keep the elbow pinned to your side.

Tips:

• Holding a hammer toward the head end adds gentle resistance — slide your grip to adjust.
• Keep the elbow still; only the forearm rotates.

Commonly done as 2–3 sets of 10–12 each way, most days.

Wrist Curls

Strengthens the forearm muscles in both directions.

What it helps: Builds balanced forearm strength in both directions — the everyday strength behind a comfortable, capable wrist and grip.

1. Rest the forearm on a table, hand off the edge, holding a light weight.
2. Palm up: curl the wrist up, then lower with control (flexion). Palm down: lift the back of the hand up, then lower (extension).
3. Move smoothly through comfortable range.

Tips:

• Light weight, controlled motion.
• Build the forearm in both directions for balance.

Commonly done as 2–3 sets of 12–15 each, most days.

Eccentric Wrist Extension

Slow lowering of the wrist that rebuilds the tendons on the outside of the elbow (tennis elbow).

What it helps: Rebuilds the wrist-extensor tendons on the outside of the elbow through slow, controlled loading — the proven way to make tennis-elbow tendons stronger and more resilient.

1. Rest the forearm on a table, palm down, hand off the edge, holding a light weight.
2. Use your other hand to help lift the wrist up.
3. Let go with the helping hand and lower the weight down slowly over 3–4 seconds. Help it back up and repeat.

Tips:

• The work is in the slow lowering, not the lift.
• Start with a very light weight (even a soup can); add load only as it stays comfortable.
• Some mild ache during/after is normal with tendon work.

Commonly done as 3 sets of 10–15, daily (or every other day).

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Scapular Y-T-W

Strengthens the muscles between and around the shoulder blades.

What it helps: Builds the mid-back and shoulder-blade muscles that anchor and position the shoulder — the foundation that lets it move and lift without pinching.

1. Lie face-down (or bend forward at a table) with arms hanging.
2. Y: raise both arms overhead into a Y, thumbs up, squeezing the shoulder blades. Lower.
3. T: raise arms straight out to the sides into a T. W: bend elbows and pull them down and back into a W, squeezing the blades. Move through each with control.

Tips:

• Lead with squeezing the shoulder blades, not shrugging.
• Light or no weight; quality over quantity.

Commonly done as 2 sets of 8–10 each, a few times a week.

Resistance Band Strengthening

Adds gentle resistance to build strength.

What it helps: Adds gentle, adjustable resistance to build strength steadily as you recover.

1. Use a band for hip or leg exercises as directed.
2. Move slowly through the range.

Commonly done a few times a week.

Core Strengthening

Supports posture and overall stability.

What it helps: Builds the core that holds your trunk steady, supporting your posture, your back, and everything you do on your feet.

1. Perform gentle core exercises as directed.

Commonly done a few times a week.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Using light hand weights or a resistance band while seated, work through gentle arm and shoulder movements.

Tips:

• Stay seated and supported while you're non-weight-bearing.

Commonly done a few times a week.

Biceps Curls (Upper Body)

Builds the arm strength you'll use for a walker or crutches after surgery.

What it helps: Builds the arm strength you rely on for lifting and carrying — and for managing crutches or a walker.

1. Sit tall or stand with your elbow close to your side.
2. Bend your elbow, bringing your hand toward your shoulder.
3. Lower slowly with control.

Tips:

• A light weight or a can of soup works well. Keep your wrist straight.

Commonly done as 2-3 sets of 5-10, daily.

Progressive Strengthening

Gradually increases strength as you recover.

What it helps: Gradually raises the challenge as you get stronger, so your body keeps adapting and improving rather than plateauing.

Commonly done as directed.

Forearm Rotation

Strengthens the muscles that turn the palm up and down.

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

1. Tuck the elbow at your side, bent 90°, holding a light weight or a hammer by the handle.
2. Slowly rotate the forearm to turn the palm up, then down, through comfortable range.
3. Keep the elbow pinned to your side.

Tips:

• Holding a hammer toward the head end adds gentle resistance — slide your grip to adjust.
• Keep the elbow still; only the forearm rotates.

Commonly done as 2–3 sets of 10–12 each way, most days.

Rowing Machine

Low-impact, full-body conditioning.

What it helps: Full-body, low-impact conditioning that builds strength and stamina without pounding the joints.

Commonly done as able.

Resistance Band External Rotation

Strengthens the rotator cuff muscles that turn the arm outward and steady the shoulder.

What it helps: Builds the rotator cuff muscles that turn the arm out and hold the ball centered in the socket — the deep stabilizers that keep the shoulder moving smoothly.

1. Anchor a band at waist height. Stand side-on and hold it in the hand farthest from the anchor, elbow bent 90° and tucked into your side.
2. Keeping the elbow pinned to your side, rotate your forearm outward, away from your body.
3. Slowly return. A small rolled towel between elbow and side helps keep good form.

Tips:

• Keep the elbow glued to your side — only the forearm moves.
• Light resistance, controlled motion.

Commonly done as 2–3 sets of 10–15, most days.

Scapular Y-T-W

Strengthens the muscles between and around the shoulder blades.

What it helps: Builds the mid-back and shoulder-blade muscles that anchor and position the shoulder — the foundation that lets it move and lift without pinching.

1. Lie face-down (or bend forward at a table) with arms hanging.
2. Y: raise both arms overhead into a Y, thumbs up, squeezing the shoulder blades. Lower.
3. T: raise arms straight out to the sides into a T. W: bend elbows and pull them down and back into a W, squeezing the blades. Move through each with control.

Tips:

• Lead with squeezing the shoulder blades, not shrugging.
• Light or no weight; quality over quantity.

Commonly done as 2 sets of 8–10 each, a few times a week.

Functional Strength Training

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
2. Add resistance gradually.

Tips:

• Quality of movement first, then load.

Commonly done several times a week.

Swimming

Low-impact, full-body conditioning.

What it helps: Full-body conditioning with the water carrying your weight, so your muscles work hard with almost no load on the joints.

Commonly done as able.

Strength Training

Maintains and builds long-term strength.

What it helps: Builds and maintains long-term strength to keep you active, resilient, and independent.

Commonly done a few times a week.

Functional Strength Training

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
2. Add resistance gradually.

Tips:

• Quality of movement first, then load.

Commonly done several times a week.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Using light hand weights or a resistance band while seated, work through gentle arm and shoulder movements.

Tips:

• Stay seated and supported while you're non-weight-bearing.

Commonly done a few times a week.

Return-to-Sport Conditioning

Overall fitness and resilience work to support a confident return.

What it helps: Overall fitness and resilience work that prepares your whole body for a confident return to sport.

1. Combine strength, endurance, balance, and sport drills.
2. Keep up calf-strength work alongside.

Tips:

• A gradual, well-rounded build helps protect against re-injury.

Commonly done ongoing.

Sport-Specific Training

Practicing the movements of your sport as you prepare to return.

What it helps: Practicing the actual movements of your sport, so your return feels natural and prepared.

1. Rehearse the specific drills and movements your activity requires.
2. Build volume and intensity gradually.

Tips:

• Confidence and symmetry are good signs of readiness.

Commonly done as cleared.

Flexibility Exercises

Maintains a comfortable range of motion.

What it helps: Keeps your joints and muscles moving through a comfortable range, so you stay supple and move with ease.

Commonly done most days.

Cycling

Low-impact endurance and motion.

What it helps: Low-impact endurance that keeps the joints moving smoothly while you build fitness — easy on the body, good for the long run.

Commonly done as able.

Low-Impact Recreational Activities

Enjoyable activities that protect your joint.

What it helps: Getting back to the activities you enjoy in ways that are kind to your joints — the whole point of building this strength.

Commonly done as you like.