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

Adam Seidl, MDBoard Certified Orthopaedic SurgeonShoulder and Elbow Specialist

Triceps Tendon Repair

PHASE 1: WEEK 1-2

PRECAUTIONS

  • Elbow immobilized in posterior splint at 60° elbow flexion for 1st 2 weeks
  • No active elbow extension 6 weeks

ROM

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

STRENGTH

  • Scapular retractions
  • Shoulder shrugs

MODALITIES

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

GOALS OF PHASE 1

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

PHASE 2: WEEK 3-6

PRECAUTIONS

  • Elbow placed in a hinged ROM brace allowing 30°-60°
  • Brace to be worn at all times except during exercise or bathing
  • Passive ROM ONLY for elbow extension

ROM

  • Hinged Brace Range of Motion Progression (ROM progression may be adjusted base on Surgeon’s assessment of the surgical repair.)
    • Week 2-3: 30°-60°
    • Week 4-5: 15°-90°
    • Week 6-7: 10°-110°
    • Week 8: 0°-125°
  • Forearm: Initiate AAROM pronation and supination
  • Progress to active pronation and supination (wk 4)
  • 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 6)

MANUAL

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

MODALITIES

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

GOALS OF PHASE 2

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

PHASE 3: WEEK 7-12

ROM

  • Week 8 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

STRENGTH

  • 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

MANUAL

  • Passive elbow extension if lacking
  • Joint mobs as needed to regain full flexion
  • Week 10: Passive or contract relax to gain full flexion if still lacking

MODALITIES

  • Ice 10-15 minutes

GOALS OF PHASE 3

  • Reach full ROM
  • Initiate loading to repair
  • Enhance neuromuscular control
  • Pain free ADLs

PHASE 4: WEEK 12+

STRENGTH:

  • 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

MODALITIES

  • Ice 15-20 minutes

GOALS OF PHASE 4

  • 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

  • UCHealth Lone Tree Clinic

    9548 Park Meadows Dr
    Lone Tree, CO 80124

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