Reverse Total Shoulder Arthroplasty — (rTSA)

Ohio State University Wexner Medical Center · OSU Sports Medicine

Weight-Bearing

Sling 4-6 wks per surgeon; no driving x 6 wks; jogging may begin at 12 wks

Key Restrictions

No IR, cross-body adduction, or extension x 12 wks (Hand Behind Back position); elevation in scaption only 4-6 wks (rTSA most stable at 30 deg ER); no forced shoulder flexion; no stretching into pain; no pushing to end ranges; no supporting body weight x 12 wks; long-term: no push-ups or bench press; 15 lb limit below shoulder height; 10 lb limit above shoulder height; subscapularis precautions: no ER PROM past neutral x 4 wks, no active IR x 8 wks (confirm with surgeon)

Timeline & Phases

7 phases: Phase I (0-2 wks, home program, pendulums), Phase II (2-4 wks), Phase III (4-6 wks, supine forward scaption PROM to 120 deg), Phase IV (6-10 wks, avoid hyperextension), Phase V (10-12 wks, no IR, adduction or cross-body movement), Phase VI (12+ wks, no lifting >6-10 lbs with operative arm), Phase VII (16+ wks, physician clearance, plyometrics no earlier than 16 wks, lifting limit 15 lbs below and 10 lbs above shoulder height, return to sport goal 6 months)

Notes

.edu site; 2023 CPG format; outcome tools: QuickDASH, Simple Shoulder Test, ASES Short Form; discharge criteria: 110-150 deg elevation, 30-50 deg functional ER; return to sport criteria explicit; most common sports: swimming, fitness, golf, tennis, pickleball; posterior instability precautions check with surgeon

Surgeon / Author

OSU Sports Medicine

Published

2023