TOTAL SHOULDER ARTHROPLASTY GUIDELINES | ANATOMICAL
The information below is meant as a guideline only. The professional skills of a therapist must come into play for each individual patient.
Dr. Ben Robinson
PHASE ONE
0-4 WEEKS
RANGE OF MOTION
Limit 0°passive ER if subscap repair for protection.
FE progress as tolerated.
Limit to 90° degrees if subscap repair.
IMMOBILIZER
0-2 weeks: Brace should be worn at all times day and night.
Brace may be off for gentle exercise only.
2-4 weeks: Brace should be worn during daytime only.
If subscap repair, brace may need to be worn longer.
EXERCISES
0-2 weeks: Grip-strengthening, elbow, wrist, hand, and pendulum exercises.
ROM at home and AAROM (pulley)
2-4 weeks: Begin cuff, deltoid isometrics; closed chain scapula, scapular retraction.
6 weeks: Limit ER to passive 0° to protect subscap repair. No active IR nor extension until 6 weeks.
PHASE TWO
4-12 WEEKS
RANGE OF MOTION
Increase as tolerated
6 weeks: Begin active and active-assisted IR and extension as tolerated after 6 weeks.
IMMOBILIZER
None
EXERCISES
4-8 weeks: Begin light resisted ER, forward flexion and abduction; closed chain scapula.
8-12 weeks: Begin resisted IR extension.
PHASE THREE
12+ WEEKS
RANGE OF MOTION
Progress to full without discomfort.
IMMOBILIZER
None
EXERCISES
Advance strength training as tolerated. Closed chain scapular rehab and functional rotator cuff strengthening; focus on anterior deltoid and teres.
Maximize scapular stabilization.
