Download Total Shoulder Arthoroplasty/Hemiarthroplasty Rehab Protocol

Weeks 1-6:

  • PROM (Partial Range Of Motion) — AAROM (Active Assist Range Of Motion) — as tolerated, except the following:
    • No active IR/backwards extension for 6 weeks. The subscapularis tendon is taken down for the surgery and then repaired afterwards. It takes about 4-6 weeks for it to grow back into the humerus and regenerate a blood and nerve supply.
  • PROM in biceps flexion for first 6 weeks
  • ROM goals: Week 1: 120º FF/20º ER at side; ABD max 75º without rotation
  • ROM goals: Week 2: 140º FF/40º ER at side; ABD max 75º without rotation
  • No resisted internal rotation/backward extension until 12 weeks post-op
  • Grip strengthening OK
  • Canes/pulleys OK if advancing from PROM
  • Heat before PT, ice after PT

Weeks 6-12:

  • Begin AAROM à AROM for internal rotation and backwards extension as tolerated, if not already begun.
  • Goals: Increase ROM as tolerated with gentle passive stretching at end ranges
  • Begin light resisted ER/FF/ABD: isometrics and bands, concentric motions only
  • No resisted internal rotation/backwards extension until 12 weeks post-op
  • No scapular retractions with bands yet

Months 3-12:

  • Begin resisted IR/BE (isometrics/bands): isometrics — light bands — weights
  • Advance strengthening as tolerated; 10 reps/1 set per exercise for rotator cuff, deltoid, and scapular stabilizers.
  • Increase ROM to full with passive stretching at end ranges
  • Begin eccentric motions, plyometrics, and closed chain exercises at 12 weeks.

Please note that these instructions are general guidelines to be followed; however, any written or verbal instructions provided by Dr. Nwachukwu supersede the instructions below and should be followed.