TOTAL SHOULDER & REVERSE TOTAL SHOULDER REPLACEMENT PHYSICAL THERAPY PROTOCOL
POST OP DAY 1 THROUGH 1st POST-OP VISIT (APPROX. WEEK 2)
Instructions:
- Sling worn at all times in public and at bedtime. For comfort only when sedentary inside
- Exercise 2-3 times per day with 10 repetitions per session
Exercises:
- AROM of hand, wrist and elbow- encourage this immediately
- AAROM and AROM forward flexion in supine and standing positions
- Active ER to neutral
- NO PROM
- NO PENDULUMS
- Scapular squeezes in the sling
1st POST-OP VISIT THROUGH 2nd POST-OP VISIT (APPROX. WEEK 6)
Instructions:
- Sling worn at all times in public and at bedtime. For comfort only when sedentary inside
- Exercise 2-3 times per day with 10-15 repetitions per session
Exercises:
- Continue AROM of hand, wrist and elbow
- AAROM and AROM in forward flexion
- No PROM
- Continue scapular squeezes
- ER to neutral, gentle abduction, NO extension, NO IR behind back
2nd POST-OP VISIT THROUGH 3RD POST-OP VISIT (APPROX. WEEK 12)
Instructions:
- Discontinue sling
- Exercises daily until maximum ROM is achieved
- Perform all activities of daily living as tolerated
Exercises:
- Continue AROM of hand, wrist and elbow
- Continue scapular stabilization exercises
- Progress to AROM for all motions supine and upright with gradual increase in ER per patient’s tolerance
- Wall-walks
- Side lying ER
- Start isometric exercises for all motions
- Wand Exercises
AFTER 3rd POST-OP VISIT AND ON
Instructions:
- All activities as patient tolerates and confidence allows
Exercises:
- Start strengthening with light weights and therabands
- Wall pushups
