Shoulder Arthroplasty

Post-operative Period

0 to 6 weeks:

  1. 2 visits per week, everyday home program

  2. Sling is to be worn at all times, including for sleep, except when doing exercises

  3. Sling may be discontinued at 2 weeks (NOT BEFORE!)

  4. Active and passive range of motion of the neck, elbow, wrist and hand should be performed 5 times/day everyday

  5. Avoid any active shoulder motion during this period (particularly avoid active internal rotation to allow the subscapularis muscle to heal)

  6. Gentle passive pendulum exercises should be started immediately to be performed 3 times a day

  7. Icing program, 3 to 5 times a day, 30 minutes each after exercises

  8. Avoid passive external rotation past ______________________ degrees

  9. Passive elevation in the scapular plane to 130 degrees (therapist, wand, wall, pulley assisted) may begin after 2 weeks

6 weeks to 3 months:

  1. 1 visit per week, 5 times a week home program

  2. Continue all exercises in previous phase (as described above)

  3. Passive and active assisted ROM exercises in all planes of shoulder motion, as tolerated

  4. Advance external rotation of the shoulder gently and to pain tolerance (subscapularis is healing)

  5. Periscapular strengthening and range of motion exercises should begin including shoulder shrugs and scapular retraction exercises

  6. Progress to active ROM once passive motion is full

  7. Isometric strengthening exercises can begin in this time period once active ROM is full

3 to 6 months:

  1. 1 visits per week, with a home program 5 times a week.

  2. Continue exercises in previous phases (as described above)

  3. A strong emphasis on periscapular strengthening and range of motion exercises should continue with scapular protraction, retraction, and elevation

  4. Rotator cuff strengthening exercises (with bands and dumbbells) may begin once active range of motion is full

6 to 9 months:

  1. 4 to 5 times a week home program. Rare clinic visits to advance home program.

  2. Continue exercises in previous phases (as described above)

  3. Active shoulder girdle, rotator cuff, and periscapular muscle strengthening exercises are the focus of this period with the emphasis to regain full strength. Strengthening exercises should be high repetition, low weights with dumbbells and bands

9 to 12 months:

  1. 3 to 5 times a week home program. May need physical therapy supervision for functional training.

  2. Begin gradual return to previous sports/activities/work duties under controlled conditions

  3. Full return to sports/activities/full work duties are pending Dr. Berkbigler’s approval based upon the following criteria:

Criteria for Return to Sports/Full Activities:

  1. Full functional range of motion

  2. No pain or tenderness

  3. Satisfactory muscular strength

  4. Satisfactory clinical examination