Reverse Shoulder Arthroplasty

Keys to a Successful Outcome

  • It is ok to have mild discomfort with exercises, but if it persists for more than one hour, the intensity of the exercises must be decreased.

  • If there is an increase in nigh pain, the program must be altered to decrease the intensity.

  • Maintain good upright shoulder girdle posture at all times and especially during sling use.

  • To avoid dislocation, avoid shoulder extension past neutral and shoulder internal rotation combined with abduction for 12 weeks (i.e. avoid shoulder motion behind lower back and hip and activities such as tucking in a shirt or reaching behind for bathroom hygiene).

  • Ultimately post-operative elevation is typically around 120 degrees, and external rotation is around 30 degrees

  • A 10-15 lb weight limit should be followed indefinitely on the operative extremity.

Phase
Brace
ROM
WB Status
Exercises
Weeks 0-1
Worn at all times (day and night); off for hygiene/therapy
PROM
NWB
Begin PROM, no shoulder AROM. Active/AAROM of the elbow, wrist, hand and C-spine.
Weeks 1-6
Worn at all times (day and night); off for hygiene/therapy
PROM/ AAROM/ AROM
NWB
Progress with PROM (FF in scapular plane to 120°, ER as tolerated). Progressively increase AAROM exercises as tolerated. AROM can begin in 3 weeks. Sub-maximal pain-free deltoid isometrics
Weeks 6-12
None
AAROM/ AROM
PWB
Progress to AROM as tolerated. Light passive stretching at end ranges. Begin resisted GH and scapular exercises with light weights. Progress strength exercises as tolerated
Months 3-12
None
FAROM
Progressive WBAT
Advance strengthening as tolerated up to 3 days a week. Begin eccentric strength exercises. Add total body conditioning. Initiate sports RTP program at 4-5 months.

 

*

**

***