Total Shoulder Arthroplasty — (TSA)

UW Health Sports Medicine · UW Health Sports Medicine (Dr. Grogan, Dr. Anderson)

Weight-Bearing

N/A (upper extremity); permanent implant precautions: no contact sports, no heavy lifting, no chopping wood, no repetitive overhead throwing, no heavy labor

Key Restrictions

No active IR 6 weeks (subscapularis protection); Dr. Grogan: sling outside house or unsafe situations 6 weeks + sleeping 6 weeks; Dr. Anderson: sling continuously (except therapy/desk work) 4 weeks + sleeping 6 weeks, no active shoulder motion 4 weeks all planes, ER limited to 20° weeks 0-4, 30° weeks 5-6, 45° weeks 7-8, 60° Phase III; no treadmill or stair master until Phase IV; no running/jumping until Phase IV

Timeline & Phases

Phase I (0-4 weeks): sling, elbow/wrist/neck AROM, ball squeezes, AAROM shoulder flex/ABD to tolerance, pendulums, pain-free shoulder isometrics (flex/ABD/ext/ER), walking/bike with sling; Phase II (4-8 weeks): PROM/AAROM all planes, progressive low-resistance shoulder isotonics, rhythmic stabilizations, scapular strengthening in neutral, postural/core, wean sling by end of week 6; Phase III (8-12 weeks): IR/ER theraband/weights at 0° ABD progressing, open/closed kinetic chain stabilizations, PNF patterns, scapular strengthening; Phase IV (12-18 weeks): multi-plane AROM with increasing velocity, RTC at 90° ABD and overhead, scapular dynamic neuromuscular control, core/lower body, stair master/light jog with 5/5 strength; Phase V (18+ weeks): work/sport specific, eccentric/endurance/velocity RTC, return to sport with surgeon clearance

Notes

UW Health Sports Medicine; one PDF shared with Reverse TSA protocol; subscapularis detached for exposure and reattached — no active IR 6 weeks for all surgeons; surgeon-specific variations: Dr. Grogan more permissive with sling, Dr. Anderson more restrictive with ER progression; permanent implant precautions apply indefinitely; no treadmill throughout rehabilitation (landing impact); criteria always time-based with physician appointments at 2, 8-10, 12, and 18 weeks

Surgeon / Author

UW Health Sports Medicine (Dr. Grogan, Dr. Anderson)