This protocol is intended to be a general outline only.  The physician reserves the right to either advance or delay this protocol as deemed necessary.  If so, this should be done by direct communication with the therapist, or in writing on the therapy referral form given to the patient on the day of surgery.

0-5 Weeks Post-Op: General Guidelines.  Patient seen 2-3x / week 

Precautions:  Protection of joint replacement.  No shoulder extension beyond neutral.  Avoid combination of adduction and IR for the first 3 months.  In supine – support shoulder with pillow behind elbow.  Use of Ultrasling with abduction wedge for 6-8 weeks.

Goals:  Progressive range of motion.  Independent ADL’s.  Minimize shoulder pain, decrease inflammation, protect repair.

  • Ice for several times / day for pain and inflammation control
  • Day 1 Post-Op:  AAROM Elbow curls without weight, and AROM grip strengthening.  These should be performed supine with gravity eliminated and shoulder in neutral position.
  • Day 1 Post-Op:  Begin supine PROM with cane.  Flexion/Elevation to 90 degrees, ER 20-30 degrees.  No IR.
  • At 1 week:  Patient may begin light aerobic exercise (bike, walkwhile wearing Ultrsling for cardiovascular fitness
  • At 2 weeks – begin submaximal (25-50%) deltoid isometrics and pariscapular.  Avoid shoulder extension on posterior deltoid activation.
  • At 2 Weeks: Begin pulley exercises for additional PROM in planes of flexion to tolerance and scaption 30 degrees.

Week 6 – 11: Patient seen 2 – 3 x / week

Precautions:  Continue to avoid shoulder hyperextension and IR.  No AROM work till 12 weeks post-op.  No lifting of objects with operative arm heavier than coffee up till week 12.    

Goals:  Progress PROM as full motion is not expected.  Limits of replacement.  Begin AROM work at 12 weeks to shoulder height only.  Control pain and inflammation.

  • Continue above exercises,
  • Discontinue wedge of Ultrasling at 6 weeks and continue full time use of sling until week 8 then discontin