Post-Operative Total Shoulder Arthoroplasty/Hemiarthroplasty Rehab Protocol
Download Total Shoulder Arthoroplasty/Hemiarthroplasty Rehab Protocol
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
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
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.
Benedict Nwachukwu, MD, MBA is an orthopedic shoulder, knee and hip specialist at Hospital for Special Surgery (HSS), nationally ranked as the best in orthopedics for 10 years by U.S. News & World Report. His academic credentials include undergrad at Columbia University, Harvard Medical School, Harvard Business School, residency at HSS, and sports medicine fellowship training at world-renowned Rush University. Dr. Nwachukwu is a member of the HSS Hip Preservation Service team that brings together the expertise and experience of some of the best hip surgeons in New York City, NY and the USA. He is a professional sports Team Physician for New York Red Bulls and NBA Player’s Association; previously serving the Chicago Bulls and Chicago White Sox.