Reverse Total Shoulder Arthroplasty

Mammoth Orthopedic Institute / Mammoth Hospital PT · Lance Georgeson PT

Weight-Bearing

N/A (shoulder) — sling in public x6 weeks; OK to remove ~wk 3 for light ADLs at side

Key Restrictions

No shoulder motion behind back (combined ADD/IR/extension) x6 weeks; active biceps flexion allowed but no weight and no eccentric loading; sling in public x6 weeks; avoid active ABD and elevation x3 weeks; no lifting weight greater than patient's ability to perform 20-30 reps with good technique throughout all phases; monitor deltoid progression — sudden increase in activity could lead to acromion stress fracture; no golf swings Phase I; golf putting/chipping Phase II; golf half swing at 3 months; full golf Phase IV

Timeline & Phases

4 phases: Phase I (0-6 wks, PROM — FF/scapular elevation + ER to 45 deg, periscapular activation no resistance, recumbent bike/walking), Phase II (6-12 wks, PROM IR to 50 deg at wk 6, AA/AROM FF/elevation supine→sitting→standing, scapular strength initiation, WB through shoulder OK from wk 8, golf putt/chip OK, 20-30 rep principle for all resistance), Phase III (12-16 wks, enhanced functional use, shoulder strength/endurance, golf half swing OK at 3 months), Phase IV (16+ wks, HEP, full golf OK — DC criteria: 80-120 deg elevation with good mechanics + ER 30 deg + light household/work duties)

Notes

References Brigham and Women's Hospital and Brian Cole reverse shoulder protocol; Lance Georgeson PT 9/2025; approved by MD 9/2025; acromion stress fracture risk with sudden deltoid activity — key precaution unique to rTSA; DC criteria explicitly listed; golf progression milestones throughout phases; 20-30 rep principle as weight selection guide; Mammoth Hospital PT (not Sierra Park PT)

Surgeon / Author

Lance Georgeson PT

Published

September 2025