Total Shoulder Arthroplasty — (TSA) — Updated 2024

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

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 wks); no lifting >2 lbs through Phase 3; limit IR strengthening in Phase 3; dressings changed on 7th day (not 2nd day); PT begins within first week post-op, 2-3x/week through 12 weeks

Timeline & Phases

Phase 1 (0-2 wks): sling, pendulums, passive supine FF to 130°, passive supine ER to 25°, peri-scapular exercises, deltoid isometrics, wrist/hand exercises; Phase 2 (2-6 wks): sling continues, PROM (FF 140°, ER 60°, abd 120°), AAROM FF to 90° with pulleys, no cross-body or IR; Phase 3 (6-12 wks): discontinue sling, PROM/AROM all directions, Theraband (FF, ext, ER), limit IR strengthening; Phase 4 (12+ wks): advance end-range ROM, restore scapulothoracic rhythm, increase resistive exercises, transition to HEP

Notes

Updated 2024 version; PT begins within first week, 2-3x/week through 12 weeks; dressings changed on day 7 (not day 2); no cross-body or IR motion in Phase 2; limit IR strengthening in Phase 3; 4 phases; discuss activity/sport restrictions with surgeon

Published

12/2024