Rehabilitation protocol
Reverse Total Shoulder Replacement Rehabilitation Protocol
The current rehabilitation protocol after a reverse 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 a reverse total shoulder replacement, which is powered by the deltoid muscle. Early care focuses on protecting the shoulder and avoiding the position that puts a reverse replacement at risk. It does NOT automatically apply to an anatomic 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. Some precautions depend on whether the subscapularis was repaired, so follow the operative note and surgeon-selected protocol when your repair status or restrictions differ, and use only the protocol identified by your surgical team.
What this protocol covers
- Rehabilitation after a reverse total shoulder replacement — the shoulder is protected before motion and strengthening advance, with strengthening later emphasizing the deltoid.
- It does NOT apply to an anatomic replacement (see the anatomic protocol), a revision, a replacement for an acute fracture, or another concurrent or complex reconstruction — those follow a different, surgeon-selected plan.
- Some early precautions depend on whether the subscapularis was repaired; follow your operative note and the plan your surgeon selected when your restrictions differ.
- 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 anatomic, a revision, for a fracture, or otherwise complex
This protocol applies to a reverse total shoulder replacement. An anatomic 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. Some precautions also depend on whether the subscapularis was repaired. 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 while it heals, controlling pain and swelling, and avoiding the position that puts a reverse replacement at risk. Only the gentle motion your surgeon permits is allowed.
Restoring motion
Gradually restoring shoulder motion within the limits your surgeon sets, respecting the reverse-replacement precautions while healing continues.
Strengthening
Progressively rebuilding strength and control as healing allows, emphasizing the deltoid and the muscles around the shoulder blade.
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. A reverse replacement often reaches a lower overhead ceiling than a native shoulder, which is expected.
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.