Total Shoulder Replacement

Total Shoulder Replacement

Phase I (Weeks 0-6)

  1. Sling immobilization for first 4-6 weeks–out of sling to do home exercise program (pendulums) twice daily.
  2. Range of Motion – PROM -> AAROM -> AROM as tolerated except No Active Internal Rotation/Backwards Extension For 6 Weeks (Protect Subscapularis Repair).- Week 1 Goal: 90° Forward Flexion, 20° External Rotation at the Side, Maximum 75°Abduction.- Week 2 Goal: 120° Forward Flexion, 40° External Rotation at the Side, Maximum 75° Abduction.
  3. Therapeutic Exercise:
    - Grip Strengthening.
    - Pulleys/Cane.
    - Elbow/Wrist/Hand Exercises.
    - Teach Home Exercises — Pendulums.
  4. Heat/Ice before and after PT sessions.

 Phase II (Weeks 6-12)

  1. Discontinue sling if still being worn.
  2. Range of Motion –AAROM/AROM –  increase as tolerated with gentle passive stretching at end ranges.- Begin Active Internal Rotation and Backward Extension as tolerated.
  3. Therapeutic Exercise:
    - Begin 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.
  4. Modalities per PT discretion.

 Phase III (Months 3-12)

  1. Range of Motion – Progress to full AROM without discomfort.
  2. Therapeutic Exercise:- Begin resisted Internal Rotation and Backward Extension exercises.- Advance strengthening as tolerated – Rotator Cuff, Deltoid and Scapular Stabilizers.- Begin eccentric motions, plyometrics and closed chain exercises.- Modalities per PT discretion.