Total Shoulder Arthroplasty

Mammoth Orthopedic Institute / Sierra Park PT · Timothy Crall MD (US Ski Team Physician); Bartlett White PA-C; Ariel Duvall PT

Weight-Bearing

N/A (shoulder) — sling at all times except shower and PT x6 weeks

Key Restrictions

Sling at all times (except shower/PT) x6 weeks; no AROM shoulder Phase I; no reaching hand behind back or excessive IR; no excessive ER stretching or sudden movements into ER; no supporting body weight Phase I-II; no heavy lifting (>5 lbs) Phase II; no upper body WB Phase II; avoid repetitive AROM against gravity with poor mechanics; aggressive stretching/mobilization not indicated if PROM milestones not met

Timeline & Phases

4 phases: Phase I (0-6 wks, sling, pendulums, PROM table slides, PROM ER to 30 deg, AROM elbow/wrist/hand), Phase II (6-12 wks, wean sling, AAROM pulleys+pole, submaximal isometrics, AROM gravity-minimized from wk 8, theraband later in phase — PROM target: 140 FF/60 ER/70 IR, active elevation to 100 deg before Phase III), Phase III (12-18 wks, progressive resisted exercises, WB exercises, return to ADLs, arm bike), Phase IV (4-6 months, advanced functional activities, recreational hobbies/sports, discharge to HEP)

Notes

References Brigham and Women's Hospital; Ariel Duvall PT March 2017; Crall MD March 2017; pendulums used in Phase I; specific PROM milestone criteria required before advancing phases; aggressive mobilization explicitly not indicated if milestones not met; no specific RTS criteria beyond return to full functional activities

Surgeon / Author

Timothy Crall MD (US Ski Team Physician); Bartlett White PA-C; Ariel Duvall PT

Published

March 2017