Adam Seidl, MD - Board Certified Orthopaedic Surgeon - Shoulder and Elbow Specialist

Adam Seidl, MDBoard Certified Orthopaedic SurgeonShoulder and Elbow Specialist

Chronic Triceps Tendon Rupture Repair

PHASE I: Protect Repair (0 to 6 weeks)


  • Maintain splint placed in OR for 2 weeks until first follow-up
  • At first post-op visit, transition to custom removable splint to be worn at all times (except showering) until 6 weeks.


  • Elbow immobilized in splint at 30° elbow flexion for 1st 6 weeks
  • No active elbow extension 6 weeks


  • Gradual ↑ Active/Passive ROM of shoulder in all planes while in splint
  • Wrist/hand/finger full AROM in splint


  • Scapular retractions
  • Shoulder shrugs


  • Hot pack before treatment
  • E-stim, TENS as needed
  • Ice 10-15 minutes after treatment


  • Control pain and inflammation
  • Protect repair
  • Independent in HEP

PHASE II: Progress Protected ROM and Function (6-12 weeks)


  • Elbow placed in a hinged ROM brace allowing 30°-45°
  • Brace to be worn at all times except during exercise or bathing
  • Passive ROM ONLY for elbow extension


  • Hinged Brace Range of Motion Progression (ROM progression may be adjusted base on Surgeon’s assessment of the surgical repair.)
  • Week 6-7: 30°-45°
  • Week 7-8: 15°-60°
  • Week 8-9: 10°-90°
  • Week 9-10: 0°-110°
  • Week 10-11: 110°-125°
  • Forearm: Initiate AAROM pronation and supination
  • Progress to active pronation and supination (wk 6)
  • Shoulder AROM as needed in brace

STRENGTH (in brace)

  • Isometric shoulder exercises
  • Supine/standing rhythmic stabilizations
  • Wrist/hand: grip strengthening
  • Standing flexion and scaption
  • Side-lying ER
  • Isometric biceps pain free (week 8)


  • Scar mobilization
  • Passive elbow extension
  • Joint mobs as needed


  • Heat/hot pack before therapy
  • US to incision as needed
  • Ice 10-15 minutes


  • Protection of repair
  • Gradual increase in ROM
  • Initiate strengthening to surrounding tissues
    • Improve scapular stability

PHASE III: Reach full ROM (12-16 weeks)


  • Week 12 progress to full ROM of elbow; discontinue brace if adequate motor control
  • Initiate UBE light resistance
  • Exercises
  • Ball roll outs on table
  • Wall walk
  • Pulley


  • Tricep/elbow extension progression
  • 6 weeks: initiate AROM
  • 8 weeks: initiate light Theraband resistance
  • Theraband IR/ER shoulder
  • Theraband bicep extension
  • Prone dumbbell Therex
  • Rhythmic stabilization


  • Passive elbow extension if lacking
  • Joint mobs as needed to regain full flexion
  • Week 14: Passive or contract relax to gain full flexion if still lacking

PHASE IV: Full ROM and Strength (>16 weeks)


  • Progress strengthening program with increase in resistance and high-speed repetition
  • Bicep curls with dumbbells
  • Initiate IR/ER exercises at 90° abduction
  • Progress rhythmic stabilization activities to include standing PNF patterns with tubing
  • Initiate plyotoss – double arm progress to single arm
  • Initiate sport specific drills and functional activities
  • Initiate interval throwing program week 16-20
  • Initiate light upper body plyometric program week 16-20
  • Progress isokinetics to 90° abduction at high speeds


  • Ice 15-20 minutes


  • Full painless ROM
  • Maximize upper extremity strength and endurance
  • Maximize neuromuscular control
  • Optimize shoulder mechanics/kinematics
  • Optimize core stability
  • Initiate sports specific training/functional training

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Location Map

  • Orthopedics - University of Colorado Hospital

    1635 Aurora Ct,4th Floor
    Aurora, CO 80045

  • Highlands Ranch Hospital

    1500 Park Central Dr #401,
    Highlands Ranch,CO 80129

  • UCHealth Steadman Hawkins Clinic Denver

    175 Inverness Drive West, Suite 200,
    Englewood, CO 80112

Credibility Logos

  • The American Board of Orthopaedic Surgery logo
  • American Academy of Orthopedic Surgeons logo
  • American Shoulder And Elbow Surgeons logo
  • Western Orthopaedic Association logo
  • Alpha Omega Alpha
  • Moon Shoulder