Total Shoulder Arthroplasty Rehabilitation Protocols

16 Total Shoulder Arthroplasty rehabilitation protocols from 16 institutions, published 2016–2025. Weight-bearing progressions vary by institution — compare them in the table below before selecting a protocol.

Compare by institution

Institution	Weight-Bearing	Key Restrictions
Boston Shoulder Institute / Massachusetts General Hospital…	Sling continuously 3-4 wks; abduction brace/pillow vs sling per surgeon intraoperative…	No shoulder AROM Phase I; no motion behind back; no excessive ER or sudden movements; no lifting; no…
Brigham and Women's Hospital — (TSA) / Hemiarthroplasty	Sling continuously 3-4 wks; no shoulder AROM Phase I; no driving x 3 wks	No AROM Phase I; no motion behind back especially IR; no excessive ER or sudden movements; no supporting body…
Dr. Michael C. Fu MD (Hospital for Special Surgery)…	N/A	Subscapularis safe zone first 6 wks: max 130 FF, max 30 ER, no abduction; no resisted IR until 10 wks; sling…
Lahey Hospital & Medical Center — / Hemiarthroplasty	N/A	Sling 3-4 wks; no AROM wks 0-4; no lifting; no excessive motion behind back; no aggressive ER stretching or…
Mammoth Orthopedic Institute / Sierra Park PT	N/A (shoulder) — sling at all times except shower and PT x6 weeks	Sling at all times (except shower/PT) x6 weeks; no AROM shoulder Phase I; no reaching hand behind back or…
Massachusetts General Hospital — (TSA) / Hemiarthroplasty	Sling in neutral rotation with abduction pillow (30-45 deg) wks 0-3; wean sling Phase II…	No shoulder AROM Phase I; no reaching behind back (especially IR); no excessive ER or ABD Phase I-II (ER ≤30…
Mountain Orthopaedics — (TSA)	N/A; sling and swathe full time initially; sling daytime only wks 2-4; discontinued with…	No active IR until wk 6; ER within surgeon-defined limits through wk 4; elevation capped at 120 degrees until…
NYU Langone Health — Anatomic Total Shoulder Arthroplasty…	N/A	Sling w/ abduction pillow 0-6 wks; PROM limited to 130 deg FF / 30 deg ER through wk 6; no abduction in Phase…
Ohio State University Wexner Medical Center — (TSA)	Sling 4-6 wks per surgeon; no driving x 6 wks	No active IR x 12 wks; IR behind back should never be pushed; no supporting body weight x 12 wks; avoid…
Orthopedic & Sports Medicine Specialists (OSMS) — (TSA)	NWB on surgical side (no pushing up from chair) Phase I; strict sling use (off only for…	Avoid active adduction, IR, shoulder extension Phase I; ER limited to neutral in scapular plane Phase I; no…
Saint Louis University (SLUCare) — Anatomic (TSA)	N/A	Sling at all times wks 0-2; limit passive ER to 30 deg wks 2-6; limit passive FF and IR to scapular plane wks…
Sanford Health — Total Shoulder Arthroplasty (TSA)	N/A – upper extremity	Sling x 6 wks; PROM only x 4 wks; AAROM at 4 wks; AROM at 6 wks; strengthening at 10 wks; avoid ER beyond 30°…
The Steadman Clinic — / Hemiarthroplasty	Sling for comfort 3 weeks; wean gradually; D/C sling completely week 4; no driving 3 weeks	No shoulder AROM weeks 0-4; no lifting; no excessive ER; no behind-back motion; no supporting body weight…
University Hospitals — (TSA)	Non-weight bearing through affected UE; sling worn (except during exercise) 4-6 wks per…	No AROM, no IR/extension past neutral, no reaching behind back, PROM limited to 90 deg flexion/30 deg ER…
University of Virginia Orthopaedic Surgery — (TSA) — 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 — (TSA)	N/A (upper extremity); permanent implant precautions: no contact sports, no heavy…	No active IR 6 weeks (subscapularis protection); Dr. Grogan: sling outside house or unsafe situations 6 weeks…