The right exercises, done at the right time, are one of the most powerful tools in recovering from a biceps tendon rupture. Here is what you need to know.
Benefits of exercise for biceps tendon rupture recovery
The exercises most helpful for biceps tendon rupture recovery fall into three categories: range-of-motion work, shoulder and shoulder blade strengthening, and progressive biceps loading. The exact mix and timing depends on whether you are in an early protective phase, an active recovery phase, or a return-to-strength phase, and whether you have had surgery.
Always follow the guidance of your physical therapist or surgeon regarding which exercises are appropriate at each stage. Exercises that are safe at 12 weeks may not be safe at 4 weeks, and moving too quickly can set back healing.8
Phase 1: early recovery
Weeks 0-6 post-surgery, or Weeks 0-4 non-surgical
During the early phase, the focus is on maintaining movement in the arm without stressing the healing tendon. These exercises are gentle and should be performed within a pain-free range.
1. Wrist flexion and extension
How to do it: Hold your arm still with the elbow supported. Gently bend your wrist up and down through its full range of motion. 8
Why it helps: This keeps the wrist and forearm mobile without loading the biceps.
2. Scapular retraction (shoulder blade squeeze)
How to do it: Stand or sit upright. Gently squeeze your shoulder blades toward your spine. Hold for 2 to 3 seconds, release. Do 2 sets of 15 repetitions daily.
Why it helps: This activates the stabilizer muscles around your shoulder blade, which support the rotator cuff and reduce stress on the healing tendon.
3. Scapular pinches
Why it helps: Helps improve shoulder blade control, which supports healthier overhead movement without loading the biceps.
How to do it: Sit or stand tall and slowly draw your shoulder blades back and slightly down, as if tucking them into your back pockets. Hold for a few seconds, then relax. Keep your neck relaxed as you move. Better scapular motion can reduce strain on the shoulder joint1.
4. Back of shoulder stretch
How to do it: Bring your affected arm across your body with your good arm pulling gently on your elbow.
Why it helps: This restores flexibility in the back of your shoulder, preventing stiffness and maintaining mobility needed for recovery.
5. Light grip strengthening
Why it helps: Helps improve function and reduce fatigue during daily tasks like opening jars or typing.
How to do it: Squeeze a soft ball or rolled towel with gentle pressure. Hold for a moment, then release. Keep the motion slow and pain free. Strengthening is a core part of conservative care for thumb base osteoarthritis and several tendon conditions
6. Finger pinch
Why it helps: Helps improve coordination and reduce strain during pinching tasks.
How to do it: Touch the tip of your thumb to each fingertip one at a time. Move slowly and keep your wrist relaxed.
Phase 2: Range of motion and early strengthening
Weeks 0-6 post-surgery, or Weeks 0-4 non-surgical
These exercises form the core of shoulder impingement rehabilitation and are the most strongly supported by clinical evidence. Begin with light resistance and progress gradually.
1. External Rotation (side-lying)
How to do it: Lie on your good side. Bend your affected elbow to 90 degrees. Keeping your elbow against your side, rotate your forearm upward. Hold briefly, lower. Start with no weight, progress to light resistance band or 1 to 2 pound weight. 2 sets of 12 to 15 repetitions, 3 times per week.
Why it helps: This directly strengthens the rotator cuff muscles responsible for rotating your arm and keeping your shoulder stable.
2. Rows (progressing to resistance band rows)
How to do it: Stand tall, hold handles or band at chest height, then pull your elbows straight back in line with your shoulders, squeezing your shoulder blades together. Start without the band, then add resistance as it becomes easier. 2 sets of 15 repetitions, 3 times per week.
Why it helps: Rows strengthen your upper back and rear shoulder muscles, which support the rotator cuff and prevent re-injury.
3. Forearm supination/pronation
Why it helps:Builds control in the forearm muscles that rotate your wrist.
How to do it:Bent your elbow at 90 degrees and keep it tucked in against your side. Slowly rotate your wrist outward (palm up) and inward (palm down), keeping the movement controlled. Repeat 10–12 times each direction for 2–3 sets. This exercise helps restore forearm coordination and reduces strain on the common extensor tendon¹ ⁶.
Phase 3: Functional strength and return to activity
Weeks 12+
As tendon healing matures and strength builds, exercises progressively increase in load and complexity. These exercises are performed at or after the 12-week mark for distal repairs, or as appropriate for non-surgical recovery.
Supported Biceps Curl (Preacher Curl)
Using a dumbbell or cable, perform a biceps curl with your upper arm resting on a supported surface (such as an incline pad). This reduces stress at the shoulder end of the biceps while still building strength. Start with a light weight and increase progressively.14
Repetitions: 12-15
Sets: 2-3
Weight: Begin very light; increase approximately 1 pound per week as tolerated
Hammer Curl
Hold a dumbbell with your thumb pointing up (neutral grip). Curl the weight up in the same motion as a standard curl, keeping the thumb-up position throughout. This variation places less rotational demand on the forearm and biceps insertion and is often introduced earlier in the strengthening phase.8
Repetitions: 10-12
Sets: 2-3
Resistance Band Rows
Anchor a resistance band at shoulder height. Hold the band with both hands and pull toward your upper chest, squeezing the shoulder blades together at the end of the movement. This builds upper back and shoulder blade strength, which supports arm mechanics as you return to full activity.15
Repetitions: 12-15
Sets: 2-3
Did you know?
Some mild discomfort during rehabilitation exercises is normal and generally safe. Research shows that exercising into manageable pain can actually help recovery for people with longer-standing shoulder impingement.1 The key is staying within a comfortable effort level, not pushing into sharp pain.
General guidelines for your recovery
Do these exercises on most days of the week. Consistency is more important than intensity. If pain increases significantly or you experience sharp shooting pain, stop and contact your doctor or therapist. Mild soreness or muscle fatigue is normal. Progress slowly and add resistance or repetitions gradually over weeks and months, not all at once.
Exercises to avoid with a biceps tendon injury
Some exercises place high demands on the biceps tendon and should be avoided or carefully introduced:
Heavy, loaded biceps curls with maximal eccentric control: The lowering phase of a heavy curl is a significant eccentric stress on the biceps, and the mechanism most likely to cause re-rupture. Avoid heavy eccentric loading until well into the return-to-strength phase and cleared by your clinical team.
Pull-ups and chin-ups: These require significant biceps loading and should not be performed until cleared in late-stage rehabilitation, typically after 4 to 6 months for distal repairs.
Isometric flexion near full elbow extension: Performing an isometric contraction with the elbow nearly straight mimics the mechanism of injury and should be avoided in early rehabilitation.13
Clinical insight
Research in post-operative rehabilitation consistently shows that a phased, criterion-based approach, where you advance through phases based on healing milestones rather than a rigid calendar, produces the best outcomes. Working with an experienced physical therapist who can monitor your progress and adjust your program is particularly valuable in the first 12 weeks after a distal biceps repair. 8
Looney AM, Day J, Bodendorfer BM, et al. Operative vs. nonoperative treatment of distal biceps ruptures: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2022;31(4):e169-e189. https://pubmed.ncbi.nlm.nih.gov/34999236/
5
Hopper HM, et al. Decreased Strength, Complication Rate and Higher Satisfaction in Conservative Treatment of Partial Distal Biceps Tendon Rupture. Orthop Rev (Pavia). 2024;16:116367. https://pubmed.ncbi.nlm.nih.gov/39006104/
McDevitt AW, et al. Physical therapy interventions used to treat individuals with biceps tendinopathy: a scoping review. Braz J Phys Ther. 2024;28(1):100586. https://pmc.ncbi.nlm.nih.gov/articles/PMC10825607/
Looney AM, et al. Operative vs. nonoperative treatment of distal biceps ruptures: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2022;31(4):e169-e189. https://pubmed.ncbi.nlm.nih.gov/34999236/
14
Michener LA, et al. An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain. JOSPT. 2020. https://doi.org/10.2519/jospt.2020.8498
15
Costa F, et al. Digital rehabilitation for musculoskeletal conditions. J Med Internet Res. 2022;24(7):e38942. https://doi.org/10.2196/38942
