REHABILITATION PROTOCOL:REVERSE TOTAL SHOULDER REPLACEMENT

Phase I (Weeks 0-6)

• Sling immobilization for first 6 weeks – out of sling to do home exercise program (pendulums) twice daily

• Therapeutic Exercise

  • Grip Strengthening

  • Elbow/Wrist/Hand Exercises

  • Teach Home Exercises - Pendulums

  • Heat/Ice before and after PT sessions

Phase II (Weeks 6-12)

• Discontinue sling

• Range of Motion – PROMAAROMAROM – increase as tolerated

  • Begin Active Internal Rotation and Backward Extension as tolerated

  • Goals: >90° Forward Flexion and 30° External Rotation

• 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

• Modalities per PT discretion

Phase III (Months 3-12)

• Range of Motion – Progress to full AROM without discomfort – gentle passive stretching at end range

• Therapeutic Exercise

  • Begin resisted Internal Rotation and Backward Extension exercise

  • Advance strengthening as tolerated – Rotator Cuff, Deltoid and Scapular Stabilizers

  • Begin eccentric motions, plyometrics and closed chain exercises

  • Modalities per PT discretion