Total Shoulder Arthroplasty — / Hemiarthroplasty

The Steadman Clinic · Dr. Peter J. Millett MD, MSc

Weight-Bearing

Sling for comfort 3 weeks; wean gradually; D/C sling completely week 4; no driving 3 weeks

Key Restrictions

No shoulder AROM weeks 0-4; no lifting; no excessive ER; no behind-back motion; no supporting body weight; small pillow behind elbow supine (protect subscapularis/anterior capsule); no heavy lifting >5 lbs weeks 6-12; avoid combined ER and ABD above 80° at all times; concomitant RC tear or fracture: progress by criteria only, not timeframes

Timeline & Phases

Phase I (0-4 weeks): PROM, pendulums, isometrics, cryotherapy; Phase II (weeks 3-6): AAROM, scapular strengthening, rhythmic stab, AROM in supine begins week 4; Phase III (weeks 6-12): anti-gravity AROM, resisted flexion/ABD/ER begins weeks 10-12, IR behind back weeks 10-12; Phase IV (weeks 12-6 months): HEP 3-4x/week, return to recreational activities and sports at 4-6 months

Notes

Dr. Peter J. Millett MD MSc; The Steadman Clinic, Vail, CO; covers both TSA and hemiarthroplasty (humeral head replacement); criteria for Phase II: PROM flexion >= 90°, ABD >= 90°, ER >= 45°, IR >= 70°; criteria for Phase III: PROM flexion >= 140°, ABD >= 120°, ER >= 60°, IR >= 70°, active elevation to 100° with good mechanics; anterior deltoid strengthening with 1-3 lbs begins week 8; discharge criteria: full non-painful AROM, maximized strength and function; return to gardening/golf/doubles tennis at 4-6 months

Surgeon / Author

Dr. Peter J. Millett MD, MSc