One hundred and one male patients with distal biceps ruptures treated with primary repair utilizing a cortical button were randomized to undergo early mobilization or standard 6 weeks of immobilization postoperatively. The primary outcome of interest was return to work. Secondary outcomes of interest included range of motion, strength, pain and function measured with the shortened Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). No differences in return to work were found between groups. The early mobilization group had significantly greater passive forearm supination than the immobilization group. The early mobilization group demonstrated significantly better QuickDASH scores but these failed to exceed minimal clinical difference cut offs. No difference in complications were noted between groups.