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Phase I (weeks 0-6) emphasizes healing, surgical repair protection, sling immobilization compliance, controlled elevation and external rotation targets, scapular mobility, home exercise adherence, and cryotherapy. Phase II (6-12) transitions to discontinuing immobilization, restoring ROM with pulleys and wand-assisted movements, and gradually rebuilding scapular and rotator cuff strength while managing pain. Phase III (12-16) advances flexibility, periscapular strengthening, rhythmic stabilization, and posterior capsule avoidance. Phase IV (16-22) focuses on neuromuscular recovery, maximizing ROM and strength, therapeutic exercise independence, sports-specific training, and discharge criteria centered on ADL independence and normalized scapulohumeral rhythm.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/physical-therapy-prescription-total-shoulder-arthroplasty-post-operative-phase-protocol/297756/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/physical-therapy-prescription-total-shoulder-arthroplasty-post-operative-phase-protocol/297756.png","ImageObject",300,407,{"name":92,"@type":93},"Patrick","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-18",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What are the primary goals in Post-Operative Phase I (Weeks 0-6)?","Question",{"text":113,"@type":114},"The protocol targets healing by reducing pain, inflammation, and swelling, restoring elevation in the scapular plane to 120°, achieving external rotation to 30°, and maintaining an independent home exercise program.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"When is the sling immobilizer discontinued and what changes in Phase II (Weeks 6-12)?",{"text":118,"@type":114},"In Phase II, the immobilizer is discontinued per physician direction, ROM is progressed using wand-assisted movements and pulleys, and rehabilitation emphasizes increasing flexibility and gently restoring strength.",{"name":120,"@type":111,"acceptedAnswer":121},"What minimum criteria must be met to advance from Phase III (Weeks 12-16)?",{"text":122,"@type":114},"Advancement requires minimal pain and inflammation, elevation in the scapular plane to 160°, external rotation to 60°, internal rotation to T12, muscle strength of 4/5, and a normal scapulohumeral rhythm with elevation under 90°.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},297756,1790232393,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52},549758146520,"https://ap-avatar.wpscdn.com/avatar/80002397d8c0411e94?_k=1775819394049821470","Physical Therapy Prescription Total Shoulder Arthroplasty  \nPOST – OPERATIVE PHASE I (WEEKS 0-6) MAXIMUM PROTECTION PHASE  \nGOALS:  \n􀂃 Promote healing : reduce pain, inflammation and swelling  \n􀂃 Elevation in plane of scapula: to 120°  \n􀂃 External Rotation: to 30 °  \n􀂃 Independent Home Exercise Program  \nTREATMENT RECOMMENDATIONS:  \nEmphasize:  \n􀂃 PROTECTING SURGICAL REPAIR  \n􀂃 Patient compliance with sling immobilization  \n􀂃 PROM elevation in scapula plane  \n􀂃 AAROM ER (supine with wand in scapula plane)  \n􀂃 Scapular mobility and stability (sidelying, progressing to manual resistance)  \n􀂃 Emphasize patient compliance to HEP and protection during ADLs  \n􀂃 Scapula retraction in sitting  \n􀂃 Codman Pendulum exercises  \n􀂃 Distal AROM of hand, wrist, elbow  \n􀂃 Cryotherapy  \n􀂃 Other:     \nPRECAUTIONS:  \n􀂃 Sling Immobilizer to be worn at all times except when exercising  \n􀂃 External Rotation to \u003C=30°  \n􀂃 MINIMUM CRITERIA FOR ADVANCEMENT:  \n􀂃 Elevation in plane of scapula: to 120°  \n􀂃 External Rotation to 30 °  \n􀂃 Independent Home Exercise Program  \n􀂃 Minimal pain or inflammation  \nMODIFICATIONS TO PHASE I:  \nPatient Name:    \nPhysician’s Signature:   M.D. Date:   /  /    \nPhysical Therapy Prescription Total Shoulder Arthroplasty  \nPOST – OPERATIVE PHASE II (WEEKS 6-12)  \nGOALS:  \n􀂃 Pain control  \n􀂃 Elevation in plane  \n􀂃 External Rotation:  \nof scapula: to 150° to 45°  \nEmphasize:  \n􀂃 Increasing flexibility  \n􀂃 Gently restoring strength  \n􀂃 Independent Home Exercise Program  \n􀂃 Begin to restore scapula and rotator cuff strength  \nTREATMENT RECOMMENDATIONS:  \n􀂃 D/C immobilizer (MD directed)  \n􀂃 P/AAROM FF and ER (using wand)  \n􀂃 Pulleys (ROM > 120 with good humeral head control)  \n􀂃 AROM (including internal rotation towel pass)  \n􀂃 Humeral head control exercises (Rhythmic Stabilization at 120)  \n􀂃 Sub-maximal isometrics Flex/Ext/ER/IR  \n􀂃 Closed kinetic chain exercises (ball stabilization)  \n􀂃 Scapular stabilization  \n􀂃 Scapula retraction and extension with elastic bands  \n􀂃 Cane extension  \n􀂃 IR stretch using strap  \n􀂃 Airdyne  \n􀂃 Modalities for pain and edema, Cryotherapy  \n􀂃 Progress HEP  \nPRECAUTIONS:  \n􀂃 Avoid painful activities of daily living  \nMINIMUM CRITERIA FOR ADVANCEMENT:  \n􀂃 Minimal pain with activities of daily lilving  \n􀂃 ROM : Elevation in plane of scapula to150°, External rotation to 45 ° ;  \n􀂃 Independent home exercise program  \nMODIFICATIONS TO PHASE II:  \nPatient Name:    \nPhysician’s Signature:   M.D. Date:   /  /    \nPhysical Therapy Prescription Total Shoulder Arthroplasty  \nPOST – OPERATIVE PHASE III (WEEKS 12-16)  \nGOALS:  \n􀂃 Elevation in plane of scapula: to 160°  \n􀂃 External Rotation: to 60°  \n􀂃 Internal rotation to T12  \n􀂃 Restore normal scapulohumeral rhythm \u003C 90 elevation  \n􀂃 Upper extremity strength 4/5  \n􀂃 Upper extremity endurance  \n􀂃 Independent Home Exercise Program  \nEmphasize:  \n􀂃 Increasing flexibility  \n􀂃 Restoring strength  \n􀂃 Avoiding posterior capsule tightness  \nTREATMENT RECOMMENDATIONS:  \n􀂃 Progress ROM as appropriate  \n􀂃 Flexibility exercises (IR stretch using opposite hand, posterior capsule stretch)  \n􀂃 Strengthening Periscapular and RC muscles: Scaption, ER & IR with elastic band  \n􀂃 Rhythmic humeral head stabilization  \n􀂃 PRE’s for scapula, elbow: bicep curl  \n􀂃 Elevation in scapula plane  \n􀂃 Progressive resistive equipment (row, chest press)  \n􀂃 Unilateral cable column Latissimus dorsi pull down  \n􀂃 PNF patterns as tolerated  \n􀂃 UE endurance (Airdyne)  \n􀂃 Modalities prn  \n􀂃 Progress HEP  \nPRECAUTIONS:  \n􀂃 Avoid painful activities of daily living  \n􀂃 Avoid movements that encourage scapula hiking or poor body mechanics  \n􀂃 Avoid stiff posterior capsule  \nMINIMUM CRITERIA FOR ADVANCEMENT:  \n􀂃 Minimal pain and inflammation  \n􀂃 Elevation in plane of scapula: to 160°  \n􀂃 External Rotation: to 60°  \n􀂃 IR to T12  \n􀂃 Muscle strength 4/5  \n􀂃 Normal scapulohumeral rhythm (\u003C 90 elevation)  \nMODIFICATIONS TO PHASE III:  \nPatient Name:    \nPhysician’s Signature:   M.D. Date:   /  /    \nPhysical Th","cbCaijmfjQ2OJSs3","https://ap.wps.com/l/cbCaijmfjQ2OJSs3","pdf",158505,"English","# Post-Operative Phase I (Weeks 0-6)\n## Goals, Treatment Recommendations, Precautions, Minimum Criteria, Modifications\n# Post-Operative Phase II (Weeks 6-12)\n## Goals, Treatment Recommendations, Precautions, Minimum Criteria, Modifications\n# Post-Operative Phase III (Weeks 12-16)\n## Goals, Treatment Recommendations, Precautions, Minimum Criteria, Modifications\n# Post-Operative Phase IV (Weeks 16-22)\n## Goals, Treatment Recommendations, Precautions, Discharge Criteria, Modifications","[{\"question\":\"What are the primary goals in Post-Operative Phase I (Weeks 0-6)?\",\"answer\":\"The protocol targets healing by reducing pain, inflammation, and swelling, restoring elevation in the scapular plane to 120°, achieving external rotation to 30°, and maintaining an independent home exercise program.\"},{\"question\":\"When is the sling immobilizer discontinued and what changes in Phase II (Weeks 6-12)?\",\"answer\":\"In Phase II, the immobilizer is discontinued per physician direction, ROM is progressed using wand-assisted movements and pulleys, and rehabilitation emphasizes increasing flexibility and gently restoring strength.\"},{\"question\":\"What minimum criteria must be met to advance from Phase III (Weeks 12-16)?\",\"answer\":\"Advancement requires minimal pain and inflammation, elevation in the scapular plane to 160°, external rotation to 60°, internal rotation to T12, muscle strength of 4/5, and a normal scapulohumeral rhythm with elevation under 90°.\"}]","Physical Therapy Prescription Total Shoulder Arthroplasty - Post-Operative Phase Protocol | PDF",1789747744]