Rehabilitation protocol
Anatomic Total Shoulder Replacement Rehabilitation Protocol
The current rehabilitation protocol after an anatomic total shoulder replacement, where the shoulder is protected while it heals and progression is criteria-based. Your surgeon and physical therapist will tailor it to you — always follow the individualized plan they give you, and use only the protocol your surgical team selected.
Who this protocol is for
Applies to an anatomic total shoulder replacement in which the subscapularis (a front rotator-cuff tendon) was taken down and repaired — the usual anatomic technique — so early motion is protected to let that repair heal. It does NOT automatically apply to a reverse replacement (which has its own protocol), a revision replacement, a replacement performed for an acute fracture, or another concurrent or complex reconstruction — those follow a different, surgeon-selected plan. If your surgeon used a different technique, the operative note and surgeon-selected protocol take precedence, and patients should use only the protocol identified by their surgical team.
What this protocol covers
- Rehabilitation after an anatomic total shoulder replacement in which the subscapularis was repaired — the shoulder is protected before motion and strengthening advance.
- It does NOT apply to a reverse replacement (see the reverse protocol), a revision, a replacement for an acute fracture, or another concurrent or complex reconstruction — those follow a different, surgeon-selected plan.
- If your surgeon used a different technique, your operative note and the plan your surgeon selected govern.
- Return to higher-demand activity is criteria-based and guided by healing, your progress, and physician clearance. Use only the protocol you are given.
If your replacement was reverse, a revision, for a fracture, or otherwise complex
This protocol applies to an anatomic total shoulder replacement in which the subscapularis was repaired. A reverse replacement, a revision, a replacement performed for an acute fracture, or another concurrent or complex reconstruction may follow different restrictions and a surgeon-selected plan. This protocol never substitutes for your operative note or the plan your surgeon selected — follow the individualized instructions your surgical team gives you.
How rehabilitation is generally structured
Rehabilitation after this procedure is usually organized into progressive phases. The phases below describe the general shape only — specific exercises, precautions, and timelines are individual and are set by your surgeon and physical therapist.
Period of protection
The earliest period after surgery, focused on protecting the shoulder and the repaired subscapularis while it heals, controlling pain and swelling, and allowing only the gentle motion your surgeon permits.
Restoring motion
Gradually restoring shoulder motion within the limits your surgeon sets, with rotation and backward-reaching movements protected while the repair heals.
Strengthening
Progressively rebuilding strength and control of the shoulder as healing allows.
Return to activity
A criteria-based progression back toward comfortable, functional activity, guided by healing, your progress, and physician clearance rather than a fixed calendar.
This overview describes the general structure of rehabilitation only. It does not replace the specific instructions of your own surgeon and physical therapist, whose guidance always takes precedence. Timelines and precautions are individual and are set for you at your appointments — and your operative note takes precedence. Use only the protocol your surgical team selected for you.