Biceps Tenodesis Rehab Protocol: The Recovery Timeline, Week by Week
Dr. Rob Letizia PT, DPTShare
Medically reviewed by Dr. Rob Letizia, PT, DPT · Doctor of Physical Therapy, 25+ years treating spine & orthopedic conditions · Last reviewed 2026-10-28
You have had a biceps tenodesis. Your arm is in a sling, the tendon has been reattached lower on the arm bone, and the questions start: how long is the sling on, when can I bend my elbow, when can I lift again? The short answer is that resisted elbow bending and palm-up turning are protected for about six weeks, biceps strengthening starts around six weeks, and sport-specific training from about two months. If your rotator cuff was repaired at the same time, that repair usually sets the pace instead; see our rotator cuff surgery recovery timeline.
This guide lays out the week-by-week path from two published surgical protocols, shows where they differ, and names the rule we use before anyone curls a weight. Your surgeon's protocol always comes first. This is the map that helps you read it.
What is the biceps tenodesis rehab protocol?
Four stages: protect, restore motion, strengthen the biceps from about six weeks, then return to sport. In the Lahey Hospital & Medical Center biceps tenodesis protocol, weeks 0–2 are a protective phase with a sling and passive motion; weeks 2–6 wean the sling and restore full motion; biceps strengthening begins at six weeks; and return to sport after about nine weeks is when your surgeon clears you. The University of Utah Health biceps tenodesis protocol follows the same order: a sling for two weeks, light strengthening usually from weeks 4–6, eccentrics and sport-specific work at two months, and collision sports at 4.5 months.
Progress through each stage depends on your surgeon's instructions and on how your shoulder and elbow are moving and feeling, not the calendar alone. Published protocols vary. The dates below are typical ranges, not promises.
Biceps Tenodesis Recovery Timeline: Week by Week
| Time after surgery | Sling and motion | What you are doing | Still off-limits |
|---|---|---|---|
| Weeks 0–2 | Sling; passive shoulder motion as tolerated, gentle on external rotation | Pendulums, posture, hand, wrist and neck movement, ice | Actively bending the elbow; resisted elbow bending or palm-up turning; lifting |
| Weeks 2–6 | Weaning off the sling; restoring full passive, then active, shoulder motion | From weeks 4–6, active shoulder motion and a gradual return to full active elbow bending and forearm turning; light shoulder strengthening as pain allows | Resisted elbow bending or palm-up turning; biceps strengthening |
| Weeks 6–8 | Full active motion is the goal | Biceps strengthening begins: eccentric curls first, then concentric; band rows, rotation and shoulder-blade work | Heavy or sudden biceps loads |
| Month 2 onward | Motion equal to the other side | Eccentrics, plyometrics and sport-specific work; return to sport when your surgeon clears you | Collision sports before about 4.5 months in one protocol; overhead pressing and wide-grip bench without your surgeon's say-so |
Sources: Lahey Hospital & Medical Center biceps tenodesis protocol; University of Utah Health biceps tenodesis protocol. These are typical milestones from published protocols, not a prescription. Your surgeon's settings and dates come first.
Weeks 0–2: what can I do right after biceps tenodesis?
The arm is in a sling, and the job is to protect the reattached tendon while keeping the shoulder from stiffening. The Lahey protocol starts passive shoulder motion as tolerated, gentle on outward rotation, with pendulums, posture work and active neck, wrist and hand movement, and no active elbow bending, no resisted elbow bending or palm-up turning, and no lifting (Lahey Hospital & Medical Center biceps tenodesis protocol). The Utah protocol begins motion immediately and progresses from passive to assisted to active as tolerated (University of Utah Health biceps tenodesis protocol).
Weeks 2–6: when can I stop wearing the sling after biceps tenodesis?
Usually between two and six weeks. The Utah protocol stops the sling at two weeks (University of Utah Health biceps tenodesis protocol). The Lahey protocol weans it across weeks 2–6 while restoring full passive motion, then progresses active shoulder motion and a gradual return to full active elbow bending and forearm turning in weeks 4–6 (Lahey Hospital & Medical Center biceps tenodesis protocol).
Shorter sling time is supported for an isolated tenodesis. A 2024 study compared 66 patients in a sling for 4–6 weeks with 69 patients in a sling for 0–2 weeks and found no significant difference in re-rupture, revision, loss of fixation, Popeye deformity, motion or function (Glover et al., Arthroscopy, Sports Medicine, and Rehabilitation 2024). It was a retrospective study, and it does not apply when a rotator cuff or labral repair was done at the same surgery.
When can I bend my elbow and lift after biceps tenodesis?
Gentle elbow bending without resistance comes back early. Resisted elbow bending and resisted palm-up turning wait about six weeks. Both protocols protect them for the first six weeks, because those two movements pull directly on the reattached tendon (Lahey Hospital & Medical Center biceps tenodesis protocol; University of Utah Health biceps tenodesis protocol). In the Lahey protocol, biceps strengthening begins at six weeks with eccentric curls (lowering the weight slowly) before regular curls, then combined elbow bending and palm-up turning (Lahey Hospital & Medical Center biceps tenodesis protocol). Light shoulder strengthening can start earlier, usually from weeks 4–6, focused on the rotator cuff, deltoid and shoulder-blade muscles (University of Utah Health biceps tenodesis protocol).
Back in the gym, the Lahey protocol's lifting precautions are worth taping to your locker: keep your hands within sight, no military press, no wide-grip bench press, and do not let your elbows drop below the plane of your body (Lahey Hospital & Medical Center biceps tenodesis protocol).
Month 2 onward: when can I go back to sport after biceps tenodesis?
The Utah protocol starts eccentrics, plyometrics and sport-specific training at two months and collision sports at 4.5 months (University of Utah Health biceps tenodesis protocol). The Lahey protocol returns to sport after about nine weeks, when your surgeon clears you, while still minimizing overhead activity (Lahey Hospital & Medical Center biceps tenodesis protocol). Light work can come back before heavy lifting. Throwing and collision-sport timing is your surgeon's decision, made on your shoulder motion, strength and how the arm tolerates the task.
The 6-Week No-Resisted-Curl Rule
No resisted elbow bending and no resisted palm-up turning for the first six weeks, and no biceps strengthening until your surgeon's protection window is over and your shoulder and elbow motion support loading. Six weeks is the window in both published protocols reviewed here (Lahey Hospital & Medical Center biceps tenodesis protocol; University of Utah Health biceps tenodesis protocol); if your surgeon's protocol sets a longer one, the longer one wins. Carrying a grocery bag, opening a jar and pulling a door are resisted elbow bending in disguise, so they count too.
The 4-Phase Biceps Tenodesis Return Protocol
- Protect (weeks 0–2): sling, passive shoulder motion, hand, wrist and neck movement; no active or resisted elbow bending, no lifting.
- Restore motion (weeks 2–6): wean the sling; full passive, then active, shoulder motion; gentle unresisted elbow bending and forearm turning; light shoulder strengthening as pain allows.
- Strengthen the biceps (weeks 6–8): eccentric curls, then concentric, then combined bending and turning; band work for the cuff and shoulder blade.
- Return (month 2 onward): plyometrics and sport-specific work, then sport when your surgeon clears you; collision sports later.
Milestones from the Lahey Hospital & Medical Center biceps tenodesis protocol and the University of Utah Health biceps tenodesis protocol.
Biceps tenodesis vs. distal biceps repair: which recovery is yours?
They are different operations on different ends of the same muscle. A biceps tenodesis reattaches the long head of the biceps at the shoulder end, usually for shoulder pain from the tendon, and it is often done alongside rotator cuff or labral surgery. A distal biceps repair reattaches the tendon at the elbow after it tears off the forearm bone, and it protects the elbow for much longer. If your surgery was at the elbow, read our distal biceps repair week-by-week timeline instead.
Red flags after biceps tenodesis
- Wound redness, drainage or fever: contact your surgeon promptly.
- A sudden new change in the shape of your upper arm (a bulge, the Popeye sign), especially after a pop or a heavy lift: contact your surgeon.
- Marked biceps cramping or pain, or a substantial new loss of strength bending the elbow or turning the palm up: contact your surgeon.
- New numbness, tingling, or a cold or pale hand: get prompt medical attention.
- Chest pain or shortness of breath: this is an emergency. Call 911.
Tenodesis complications can include fixation failure or deformity, persistent pain, stiffness, infection, and nerve or blood-vessel injury. Most recoveries are uneventful, and a new symptom is worth a call rather than a wait.
Started with an AI assistant? Bring the plan in.
ChatGPT, Gemini and Claude will usually give you a sensible phased outline and tell you to follow your surgeon's protocol, and that is right. What none of them can do is see how your shoulder moves, check whether the tendon tolerates its first eccentric curl, or tell whether your rotator cuff repair or your tenodesis should set the pace. If an assistant has given you a plan, bring it in with your surgeon's protocol, and we will match the two week by week.
Frequently asked questions: biceps tenodesis recovery
What is the rehab protocol after biceps tenodesis?
Most protocols run in four stages: protect the tenodesis in a sling with passive shoulder motion (weeks 0-2), wean off the sling and restore full motion (weeks 2-6), start biceps strengthening at about six weeks, then build toward sport and heavier work from about two months. Through the first six weeks the rule is no resisted elbow bending and no resisted palm-up turning. Your surgeon's protocol overrides any general timeline, and if your rotator cuff or labrum was repaired at the same surgery, that repair usually sets the pace.
How long do you wear a sling after biceps tenodesis?
Usually two to six weeks. The University of Utah Health protocol uses a sling for the first two weeks; the Lahey protocol uses it for comfort in weeks 0-2 and weans it through week 6. A 2024 study of 135 patients after isolated biceps tenodesis found no significant difference in re-rupture, revision, loss of fixation, Popeye deformity, motion or function between a 0-2 week sling and a 4-6 week sling (Glover et al., 2024). If you also had a rotator cuff repair, follow the cuff repair's sling time.
When can I bend my elbow after biceps tenodesis?
Gently, without resistance, after the first two weeks in the Lahey protocol, which progresses to full active elbow bending and forearm turning across weeks 4-6. Resisted elbow bending and resisted palm-up turning stay off-limits for the first six weeks in both protocols reviewed here, because they pull on the tendon where it was reattached.
When can I lift weights after biceps tenodesis?
Biceps strengthening starts at about six weeks, with light eccentric curls before regular curls (Lahey protocol). Eccentrics, plyometrics and sport-specific training begin at about two months in the University of Utah Health protocol. When you return to the gym, the Lahey protocol advises keeping your hands within sight, skipping military press and wide-grip bench press, and not letting your elbows drop below the plane of your body.
How long is recovery after biceps tenodesis?
Plan on about two months before sport-specific training and longer for contact sport: the University of Utah Health protocol allows collision sports at 4.5 months. Daily activities with the arm usually come back well before that. Light work may come back before heavy lifting, and the timing for throwing and collision sports is your surgeon's call.
Is biceps tenodesis recovery different if I also had rotator cuff repair?
Yes. When a tenodesis is done alongside a rotator cuff or labral repair, the slower repair usually governs the sling time and the motion limits. The evidence that an isolated tenodesis tolerates early sling removal (Glover et al., 2024) does not apply to a combined repair. Follow your surgeon's protocol and our rotator cuff surgery recovery timeline for the cuff side.
When should I call my surgeon after biceps tenodesis?
Call for wound redness, drainage or fever; a sudden new change in the shape of your upper arm (a bulge, the so-called Popeye sign); marked biceps cramping or pain; or a substantial new loss of strength bending the elbow or turning the palm up. Tenodesis complications can include fixation failure, persistent pain, stiffness, infection and nerve or blood-vessel injury, so new numbness, tingling or a cold, pale hand needs prompt attention.
Physical therapy after biceps tenodesis in Wayne and Northern New Jersey
Spectrum Therapeutics of NJ is a one-on-one physical therapy clinic in Wayne, serving Passaic County and Northern New Jersey, led by Dr. Rob Letizia, PT, DPT. After a biceps tenodesis we work from your surgeon's protocol, restore your shoulder motion, start biceps loading only when the protection window is over, and keep in touch with your surgeon at each phase change. See our shoulder rehabilitation page and our post-surgical rehabilitation page. If you have any Medicare plan, including Medicare Advantage and Medigap, a doctor's prescription is required.
