Physical Therapy Protocol

Reverse Total Shoulder Replacement

A structured, phase-by-phase recovery guide for patients and physical therapists following reverse shoulder replacement with Dr. Kee.

Recommended Frequency
PT/OT 2–3x per week
Typical Duration
8–12 weeks

Precautions

Weeks 0–4 Goal: Allow soft tissue healing, preserve passive motion
  • Wear sling for 4 weeks
  • While lying down, support the elbow with a pillow
  • No shoulder extension for 4 weeks
  • No active range of motion for the first 2 weeks
  • No lifting objects or supporting body weight with the operative arm
  • No internal rotation
  • Full mobilization of elbow, wrist, and hand encouraged
  • Ice 3–4x daily for the first 3 days
Motion (Passive)Weeks 1–2Weeks 2–4
Forward Elevation0–30°0–100°
External Rotation0–15°
Weeks 4–6 Goal: Begin deltoid strengthening, avoid dislocation
  • Begin submaximal, pain-free deltoid isometrics in the scapular plane
  • Ice following exercises
  • No weights yet
Weeks 6–8 Goal: Improve passive motion, begin restoring active motion
  • Start passive internal rotation to tolerance, up to 50° in the scapular plane
  • Begin active-assisted and active range of motion — forward flexion, elevation, and external rotation — starting supine, then progressing to sitting or standing
Motion (Passive)Weeks 4–8Weeks 8–12
Forward Elevation0–120°0–140°
External Rotation0–30°0–45°
Weeks 9–12 Goal: Continue improving motion and active strength
  • Active range of motion with resistive bands and light weights (1–3 lbs)
Weeks 12–16 Goal: Enhance strength and endurance
  • No lifting objects heavier than 20 lbs overhead
  • Progress to gentle resisted flexion and elevation in standing
Note for physical therapists: This protocol is a general guideline. Progression should always be individualized based on intraoperative findings, tissue quality, and patient presentation. Please contact our office with any questions about a specific patient's protocol.

Questions About Your Recovery?

Our care team is available to answer questions about your protocol or recovery progress.