Reverse Total Shoulder Arthroplasty Rehabilitation Protocols

14 Reverse Total Shoulder Arthroplasty rehabilitation protocols from 14 institutions, published 2019–2025. Weight-bearing progressions vary by institution — compare them in the table below before selecting a protocol.

Compare by institution

Institution	Weight-Bearing	Key Restrictions
Brigham and Women's Hospital — (rTSA)	Sling/immobilizer 4-6 wks (4 wks isolated rTSA; 6 wks with tendon transfer or…	Dislocation precautions x 10-12 wks: avoid shoulder extension beyond neutral AND combination of adduction +…
Dr. Michael C. Fu MD (Hospital for Special Surgery)	N/A	Avoid shoulder extension posterior to frontal plane; avoid IR/adduction/extension (no reaching behind back)…
Lahey Hospital & Medical Center — (rTSA)	N/A	Sling 3-4 wks (6 wks if revision); no AROM wks 0-6; no shoulder extension beyond neutral or behind back for…
Mammoth Orthopedic Institute / Mammoth Hospital PT	N/A (shoulder) — sling in public x6 weeks; OK to remove ~wk 3 for light ADLs at side	No shoulder motion behind back (combined ADD/IR/extension) x6 weeks; active biceps flexion allowed but no…
Massachusetts General Hospital — (rTSA)	Sling in neutral rotation with abduction pillow (30-45 deg) wks 0-3; wean sling Phase II…	No shoulder AROM or AAROM Phase I; no PROM into IR Phase I; no reaching behind back (especially IR) x 12 wks…
NYU Langone Health — (rTSA)	N/A	Sling 24/7 x2 wks then wean; avoid shoulder extension (elbow must stay in front of body at all times); avoid…
Ohio State University Wexner Medical Center — (rTSA)	Sling 4-6 wks per surgeon; no driving x 6 wks; jogging may begin at 12 wks	No IR, cross-body adduction, or extension x 12 wks (Hand Behind Back position); elevation in scaption only…
Orthopedic & Sports Medicine Specialists (OSMS) — (rTSA)	NWB on surgical side (no pushing up from chair) Phase I; strict sling use (off only for…	No shoulder active ROM Phase I; small pillow/towel behind elbow when supine to avoid hyperextension; formal…
Sanford Health — Reverse Total Shoulder Arthroplasty (rTSA)	N/A – upper extremity	Sling x 4-6 wks; PROM only x 4 wks; AAROM at 4 wks; AROM at 6 wks; no strengthening x 10 wks; avoid ER beyond…
Sutter Health / Palo Alto Medical Foundation — (rTSA)	N/A (upper extremity)	Sling at all times except exercise/dressing/eating/showering wks 0-3; wean sling wks 3-6 (night + out of…
UCLA Department of Orthopaedic Surgery - Sports Medicine…	N/A (upper extremity)	Sling immobilization; Stage I PROM/AAROM limited to <120° elevation (typically 90° tolerated), 0° ER, 45°…
University Hospitals — (rTSA)	Non-weight bearing through affected UE; abduction sling worn 4-6 wks per surgeon…	Avoid shoulder adduction, extension and IR for 12 weeks (dislocation precaution) unless directed by surgeon…
University of Virginia Orthopaedic Surgery — (rTSA) — Updated…	NWB surgical UE	Sling at all times except HEP and PT for 6 weeks; sleep in sling; no cross-body or IR motion in Phase 2 (2-6…
UW Health Sports Medicine — (rTSA)	N/A (upper extremity); permanent implant precautions: no contact sports, no heavy…	Dr. Grogan: sling for comfort/safety only (crowds, ice, uneven ground) — highly permissive; Dr. Anderson…