Reza Jazayeri, MD | DOCS Health
Dr. Reza Jazayeri is a double board-certified orthopedic surgeon and sports medicine physician and Director of Longevity & Optimization at DOCS Health. He completed his orthopedic surgery residency at NYU-Hospital for Joint Diseases and his sports medicine fellowship at Kerlan-Jobe Orthopaedic Clinic. Learn more about Dr. Jazayeri’s training and approach.
About this guide
Stay in the gym, protect the repair. This guide gives athletes and bodybuilders a muscle-group-by-muscle-group timeline for returning to lifting after distal biceps surgery. It covers two surgeries side by side:
- Acute repair: the tendon is reattached within 6 weeks of the injury
- Chronic reconstruction: an older tear is rebuilt with an allograft (donor tendon)
Your legs, core, and other arm can keep training almost from the start. Your own timeline may differ based on tendon quality and what was found at surgery. Your surgical report and Dr. Jazayeri’s instructions always come first.
Your surgery: what each one protects
Both surgeries protect against bending the elbow and turning the palm up against resistance. A graft takes longer to incorporate, so a chronic reconstruction runs about 2 to 4 weeks behind at every step, and heavy lifting comes back later.
On a phone, swipe horizontally to view all table columns.
| Consideration | Acute repair (< 6 weeks) | Chronic reconstruction (allograft) |
|---|---|---|
| Lifting limit | Nothing heavier than a coffee cup for about 6 weeks | Nothing heavier than a coffee cup for about 8 weeks |
| Light curls | Week 6 to 8 | Week 8 to 10 |
| Heavy curls | Month 4 to 6 | Month 6 |
| Max-effort lifting, contact sports | Month 6, with clearance | Month 9, with clearance |
At a glance: what you can train, and when
Your legs, core, cardio, and other arm can train from week 1. Curls, pulling, and pressing come back last.
Legs, core and cardio come back weeks before curls and pulling. Earliest starts for an acute repair. A chronic reconstruction runs 2 to 4 weeks behind.
| Body part | Weeks 0 to 6 | Weeks 6 to 12 | Months 3 to 4 | Months 4 to 6 | Month 6+ |
|---|---|---|---|---|---|
| Cardio | Training/progressing: Walk, bike | Training/progressing: Running | Training/progressing: Swim, rower | Training/progressing: Full training | Training/progressing: Full training |
| Legs and glutes | Training/progressing: Machines | Training/progressing: Hack squat | Training/progressing: Back squat | Training/progressing: RDL, deadlift | Training/progressing: Full training |
| Core | Training/progressing: Floor core | Training/progressing: Forearm plank | Training/progressing: Planks | Training/progressing: Ab wheel | Training/progressing: Full training |
| Non-surgical arm | Training/progressing: Train freely | Training/progressing: Train freely | Training/progressing: Train freely | Training/progressing: Train freely | Training/progressing: Train freely |
| Biceps: acute | Light/limited: No-weight motion | Light/limited: Light curls | Light/limited: Cable, DB curls | Training/progressing: Heavy curls | Training/progressing: Max effort |
| Biceps: chronic | Not yet/protected: Protected | Light/limited: Light curls wk 8 | Light/limited: Light curls | Light/limited: Cable, DB curls | Training/progressing: Heavy curls |
| Triceps | Not yet/protected: Not yet | Light/limited: Pushdowns | Light/limited: Overhead ext. | Training/progressing: Close-grip bench | Training/progressing: Full training |
| Shoulders | Light/limited: Isometrics | Light/limited: Light raises | Training/progressing: Overhead press | Training/progressing: Full training | Training/progressing: Full training |
| Back | Light/limited: Squeezes | Light/limited: Band rows | Light/limited: Cable rows | Training/progressing: Pulldowns | Training/progressing: Pull-ups |
| Chest | Not yet/protected: Not yet | Light/limited: Machine press | Light/limited: DB bench | Training/progressing: Barbell bench | Training/progressing: Full training |
Chronic allograft reconstruction: heavy curls at month 6, max-effort lifting at month 9.
Exercise timeline by body part
Times are from the day of surgery. Each one is the earliest start, if the elbow is pain-free and you have met the milestones below.
Cardio and conditioning
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Walking, incline treadmill (hands off the rails) | Week 1 | Week 1 |
| Upright or recumbent bike (no weight on the surgical arm) | Week 1 | Week 1 |
| Elliptical, legs only | Week 2 | Week 2 |
| Jogging and running | Week 4 | Week 6 |
| Swimming | Month 3 | Month 4 |
| Rowing machine, assault bike | Month 3 to 4 | Month 5 |
Legs and glutes
Avoid any leg exercise where the surgical hand grips a bar or carries weight.
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Leg extension, leg curl, calf raise, hip machines, leg press | Week 1 to 2 | Week 1 to 2 |
| Belt squat, bodyweight split squats | Week 2 | Week 2 |
| Hack squat, pendulum squat (hold with the other hand) | Week 4 | Week 6 |
| Barbell back squat (elbows bent under the bar) | Month 3 | Month 4 |
| Dumbbell lunges, Romanian deadlift | Month 4 | Month 5 |
| Deadlift, farmer’s carries (double overhand grip, no mixed grip) | Month 4 to 5 | Month 6 |
Core
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Crunches, dead bugs, reverse crunches | Week 1 to 2 | Week 1 to 2 |
| Forearm plank, side plank | Week 8 | Week 10 |
| Ab wheel, hanging leg raises | Month 4 | Month 5 to 6 |
Non-surgical arm
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Single-arm machine and dumbbell work, seated and stable | Week 1 | Week 1 |
Biceps and forearm (surgical side)
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Ball squeezes, finger work | Week 1 | Week 1 |
| Elbow and forearm motion, no weight, as your therapist directs | Week 1 to 2 | Week 2 to 4 |
| Light wrist curls, forearm supported | Week 4 to 6 | Week 6 to 8 |
| Light dumbbell curls (1 to 5 lb) | Week 6 to 8 | Week 8 to 10 |
| Resisted palm-up turning (supination) | Week 8 | Week 10 to 12 |
| Cable and dumbbell curls, progressive | Week 12 | Month 4 |
| Heavy barbell and EZ-bar curls | Month 4 to 6 | Month 6 |
| Heavy negatives, max-effort curls | Month 6 | Month 9 |
Triceps
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Light band or cable pushdowns | Week 6 | Week 8 |
| Progressive pushdowns, kickbacks, overhead extensions | Month 3 | Month 4 |
| Close-grip bench, skull crushers, dips | Month 4 to 5 | Month 6 |
Shoulders (surgical side)
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Shoulder isometrics, arm at side | Week 2 | Week 2 |
| Band external and internal rotation | Week 4 to 6 | Week 6 |
| Light lateral raises | Week 6 to 8 | Week 8 to 10 |
| Overhead press | Month 3 | Month 4 |
Back
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Shoulder-blade squeezes, no weight | Week 1 | Week 1 |
| Light band rows | Week 8 | Week 10 |
| Cable and machine rows | Month 3 | Month 4 |
| Lat pulldowns | Month 3 to 4 | Month 4 to 5 |
| Pull-ups and chin-ups (chin-ups last) | Month 5 to 6 | Month 6 to 8 |
Chest
| Exercise | Acute repair | Chronic reconstruction |
|---|---|---|
| Machine chest press, light | Week 8 to 10 | Week 12 |
| Push-ups, dumbbell bench press | Month 3 | Month 4 |
| Barbell bench press | Month 4 | Month 5 to 6 |
| Flyes (load the biceps at full stretch) | Month 4 to 5 | Month 6 |
Sport and high-risk lifts
| Activity | Acute repair | Chronic reconstruction |
|---|---|---|
| Max-effort lifting, strongman | Month 6 | Month 9 |
| Combat and contact sports | Month 6, with clearance | Month 9, with clearance |
Training rules
- Start every new arm exercise at about 30% of your old working weight. Add no more than about 10% per week, and only if the elbow stays pain-free.
- Protect the two motions that load the repair: bending the elbow and turning the palm up against resistance.
- No mixed-grip deadlifts, ever, if you can avoid it. The underhand side is a common way the distal biceps tears.
- No sets to failure, forced reps, or heavy negatives for the first 6 months (9 months after reconstruction).
- Never catch a falling load with the surgical arm, such as a dropped dumbbell or a slipping bar.
- Physical therapy comes first. Gym work adds to your therapy; it never replaces it.
Milestones, not just dates
- Before light resistance: wound healed, near-full elbow and forearm motion, no pain at rest
- Before pulling and pressing: strength at least 70 to 80% of your other side
- Before heavy curls and max-effort lifting: strength at least 90% of your other side, and surgeon clearance
Call the office if you notice
- A sudden pop, new bruising, or a change in the shape of the upper arm
- Numbness or tingling in the forearm or thumb that is new or worsening
- Fever, redness, or drainage from the incision
Your Surgical Athlete plan
- Before surgery: Metabolic Report Card labs check hormonal, metabolic and nutritional markers. Targeted amino acid supplements start one week before surgery. We also discuss peptide therapeutics and a muscle-centric diet to limit muscle loss.
- In the operating room: orthobiologics such as PRP or bone marrow aspirate concentrate (BMAC) may be used to support healing. For chronic tears, an allograft rebuilds the missing tendon length.
- After surgery: you keep training everything the repair allows, using the timeline above.
Let’s talk openly about your training
I work with many athletes and bodybuilders, and I know anabolic steroids, peptides, and supplements are often part of the picture. That conversation is welcome in my office, without judgment. Being honest lets us plan timing, decide what to continue, taper or stop, and support healing. Please don’t stop or change anything on your own before we talk.
Related recovery resources
- Athlete’s Guide: Return to Training After Orthopedic Surgery
- Distal biceps injury and repair
- Nutrition before orthopedic surgery
- Download this recovery guide (PDF)
Your comeback starts before surgery
Ready to plan your recovery? Call 1-844-JAZ-0911 or email [email protected] to schedule a consultation with Dr. Jazayeri at DOCS Health in Beverly Hills or Westlake Village.
This guide is for education only and isn’t a substitute for personal medical advice. Timelines vary with each tear, repair, and patient. Always follow your surgeon’s and physical therapist’s specific instructions.
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