Total Shoulder Arthroplasty / Hemiarthroplasty Rehabilitation
- PROM – AAROM – as tolerated, except the following. . .
- No active IR/backwards extension for 6 weeks. The subscapularis tendon is taken down for the surgery and then repaired afterwards. It takes about 4-6 weeks for it to grown back into the humerus and regenerate a blood and nerve supply.
- PROM in biceps flexion for first 6 weeks
- ROM goals: Week 1: 120º FF/20º ER at side; ABD max 75º without rotation
- ROM goals: Week 2: 140º FF/40º ER at side; ABD max 75º without rotation
- No resisted internal rotation/backward extension until 12 weeks post-op
- Grip strengthening OK
- Canes/pulleys OK if advancing from PROM
- Heat before PT, ice after PT
- Begin AAROM à AROM for internal rotation and backwards extension as tolerated, if not already begun.
- Goals: Increase ROM as tolerated with gentle passive stretching at end ranges
- Begin light resisted ER/FF/ABD: isometrics and bands, concentric motions only
- No resisted internal rotation/backwards extension until 12 weeks post-op
- No scapular retractions with bands yet
- Begin resisted IR/BE (isometrics/bands): isometrics à light bands à weights
- Advance strengthening as tolerated; 10 reps/1 set per exercise for rotator cuff, deltoid, and scapular stabilizers.
- Increase ROM to full with passive stretching at end ranges
- Begin eccentric motions, plyometrics, and closed chain exercises at 12 weeks.