Reverse Total Shoulder Replacement

Phase I (Weeks 0-6)

1. Sling immobilization  for first 6 weeks–out of sling to do home exercise program (pendulums) twice daily
2. Therapeutic ExerciseGrip StrengtheningElbow/Wrist/Hand ExercisesTeach Home Exercises — Pendulums
3. Grip Strengthening
4. Elbow/Wrist/Hand Exercises
5. Teach Home Exercises — Pendulums
6. Heat/Ice before and after PT sessions 

 Phase II (Weeks 6-12)

1. Discontinue sling
2. Range of Motion –PROM -> AAROM -> AROM –  increase as toleratedBegin Active Internal Rotation and Backward Extension as toleratedGoals: >90° Forward Flexion and 30° External Rotation
3. Begin Active Internal Rotation and Backward Extension as tolerated
4. Goals: >90° Forward Flexion and 30° External Rotation
5. Therapeutic ExerciseBegin light resisted exercises for Forward Flexion, External Rotation and Abduction – isometrics and bands – Concentric Motions Only No Resisted Internal Rotation, Backward Extension or Scapular Retraction
6. Begin light resisted exercises for Forward Flexion, External Rotation and Abduction – isometrics and bands – Concentric Motions Only
7.  No Resisted Internal Rotation, Backward Extension or Scapular Retraction
8. Modalities per PT discretion

 Phase III (Months 3-12)

1. Range of Motion – Progress to full AROM without discomfort – gentle passive stretching at end range
2. Therapeutic ExerciseBegin resisted Internal Rotation and Backward Extension exercisesAdvance strengthening as tolerated – Rotator Cuff, Deltoid and Scapular StabilizersBegin eccentric motions, plyometrics and closed chain exercisesModalities per PT discretion
3. Begin resisted Internal Rotation and Backward Extension exercises
4. Advance strengthening as tolerated – Rotator Cuff, Deltoid and Scapular Stabilizers
5. Begin eccentric motions, plyometrics and closed chain exercises
6. Modalities per PT discretion