Revision Reverse Shoulder Arthroplasty

Phase I: Protect the Replacement (0 to 6 weeks)

• Sling/immobilizer should be worn AT ALL TIMES for 2 weeks then when sleeping and out in public
• Initiate exercise program 3 times per day immediately:
1. Immediate elbow, forearm and hand AROM
• Pendulums may begin at 2 weeks after instruction by therapist
• At 2 weeks begin PASSIVE supine ROM to 130 FE and 30 ER

Phase II: PROM/AAROM (6 to 8 weeks)

• Discontinue sling at all times
• Lifting restriction of 2-3 pounds
• Advance AAROM and PROM as tolerated
1. Maintain ER limit of 30 until 8 weeks.
2. Advance forward elevation as tolerated
• Scapular stabilizer strengthening.

Phase III: AROM/Strengthening (>8 weeks)

• Advance AROM as tolerated
• Strengthen rotator cuff and shoulder musculature (Isometrics, Theraband, dumbbell, etc). AVOID RESISTED IR OR EXTENSION UNTIL 10 WEEKS.
• Lifting restriction of 10 pounds until 3 months
• Incorporate low level functional activities at 3 months (swimming, water aerobics, light tennis, jogging)
• Start higher level activities at 4 months (tennis, light weight training, and golf). • Initiate functional progression to sports specific activities at 4 months.

Reverse Shoulder Arthroplasty for Chronic Dislocation

Phase I: Protect the Repair (0 to 6 weeks)

• Staples to be removed at 14 days after surgery
• Sling/immobilizer should be worn AT ALL TIMES other than when showering
• Initiate exercise program 3 times per day immediately: Immediate elbow, forearm and hand AROM
1. Pendulums may begin at 2 weeks after instruction by therapist
• Passive Supine ROM to 90 degrees FE and 20 degrees ER.

Phase II: PROM/AAROM (6 to 8 weeks)

• Discontinue sling at all times
• Lifting restriction of 2-3 pounds
• Advance AAROM and PROM as tolerated
1. Maintain ER limit of 30 until 8 weeks.
2. Advance forward elevation as tolerated
• Scapular stabilizer strengthening.

Phase III: AROM/Strengthening (>8 weeks)

• Advance AROM as tolerated
• Strengthen rotator cuff and shoulder musculature (Isometrics, Theraband, dumbbell, etc). AVOID RESISTED IR OR EXTENSION UNTIL 10 WEEKS.
• Lifting restriction of 10 pounds until 3 months
• Incorporate low level functional activities at 3 months (swimming, water aerobics, light tennis, jogging)
• Start higher level activities at 4 months (tennis, light weight training, and golf).
• Initiate functional progression to sports specific activities at 4 months.

Reverse Shoulder Arthroplasty for Fracture

Phase I: Protect the Tuberosity (Rotator Cuff) Repair (0 to 6 weeks)

• Staples to be removed at 14 days after surgery
• Sling/immobilizer should be worn AT ALL TIMES other than when showering
• Initiate exercise program 3 times per day immediately:
1. Immediate elbow, forearm and hand AROM
• Pendulums may begin at 2 weeks after instruction by therapist

Phase II: PROM/AAROM (6 to 8 weeks)

• Discontinue sling at all times
• Lifting restriction of 2-3 pounds
• Advance AAROM and PROM as tolerated
1. Maintain ER limit of 30 until 8 weeks.
2. Advance forward elevation as tolerated
• Scapular stabilizer strengthening.

Phase III: AROM/Strengthening (>8 weeks)

• Advance AROM as tolerated
• Strengthen rotator cuff and shoulder musculature (Isometrics, Theraband, dumbbell, etc). AVOID RESISTED IR OR EXTENSION UNTIL 10 WEEKS.
• Lifting restriction of 10 pounds until 3 months
• Incorporate low level functional activities at 3 months (swimming, water aerobics, light tennis, jogging)
• Start higher level activities at 4 months (tennis, light weight training, and golf).
• Initiate functional progression to sports specific activities at 4 months.

Revision Shoulder Hemiarthroplasty

Phase I: Protect the Replacement (0 to 10 weeks)

• Sling/immobilizer should be worn AT ALL TIMES for 6 weeks then when sleeping and out in public
• Initiate exercise program 3 times per day immediately:
1. Immediate elbow, forearm and hand AROM
• Pendulums may begin at 2 weeks after instruction by therapist
• At 6 weeks begin PASSIVE supine ROM to 130 FE and 30 ER

Phase II: PROM/AAROM (10-12 weeks)

• Discontinue sling at all times
• Lifting restriction of 2-3 pounds
• Advance AAROM and PROM as tolerated
1. Maintain ER limit of 30 until 8 weeks
2. Advance forward elevation as tolerated
• Scapular stabilizer strengthening.

Phase III: AROM/Strengthening (> 12 weeks)

• Advance AROM as tolerated
• Strengthen rotator cuff and shoulder musculature (Isometrics, Theraband, dumbbell, etc). AVOID RESISTED IR OR EXTENSION UNTIL 10 WEEKS.
• Lifting restriction of 10 pounds until 3 months
• Incorporate low level functional activities at 3 months (swimming, water aerobics, light tennis, jogging)
• Start higher level activities at 4 months (tennis, light weight training, and golf).
• Initiate functional progression to sports specific activities at 4 months.

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