Total Shoulder Replacement Physical Therapy Protocol

Rehabilitation after total shoulder replacement focuses on restoring motion and function while protecting soft tissue healing and long-term implant stability.

The subscapularis tendon at the front of the shoulder is especially important after anatomic total shoulder replacement and must be protected during early recovery.

Phase 1: Early Protection — 0 to 6 Weeks

• Sling use as instructed
• Hand, wrist, and elbow motion
• Passive forward elevation as directed
• Protected external rotation
• No pushing up from a chair
• No heavy lifting
• Avoid excessive external rotation or extension

The goal is to restore early comfort and motion while protecting the front of the shoulder.

Phase 2: Motion Restoration — 6 to 12 Weeks

• Progress passive range of motion
• Begin assisted motion
• Progress toward active shoulder motion
• Begin gentle scapular stabilization
• Continue protection from forceful internal rotation or pushing

Progression depends on soft tissue healing, comfort, motion, and surgeon-specific restrictions.

Phase 3: Strengthening and Functional Recovery — 3 to 6 Months

• Progressive deltoid strengthening
• Rotator cuff strengthening when appropriate
• Scapular strengthening
• Functional reaching progression
• Gradual return to golf and recreational activity

The goal after total shoulder replacement is smooth, comfortable motion with durable long-term shoulder function.