This protocol is applicable to patients treated with an anatomic total shoulder replacement.

Shoulder Replacement Stemmed

0-4 weeks: Arm in a sling for comfort. Sling may be removed to perform exercises, and for bathing, dressing and at meal times. Perform pendular exercises as well as exercises for the hand, wrist and elbow to maintain mobility. Encourage active assisted elevation in flexion to 90 degrees using table slides. Avoid external rotation beyond 10 degrees or limit specified at surgery. 

5-6 weeks: Discard sling. Restore normal glenohumeral and scapulothoracic motion and function with active-assisted to active ROM exercises including overhead elevation as tolerated. Perform scapular exercises. Avoid external rotation as above. 

6-12 weeks: Continue with ROM stretches including overhead elevation promoting active control. Encourage gentle stretching in external rotation. May start isometrics. Avoid free weights.

>12 weeks: Start rotator cuff strengthening with theraband. May lift and carry objects as tolerated. 

>16 weeks: Patients in manual occupations may return to work in a phased manner at this stage.