Total Shoulder Replacement Rehabilitation
Specialized rehab for anatomic and reverse total shoulder arthroplasty.
Shoulder Replacement — aTSA and rTSA
Whether you had an anatomic or reverse total shoulder, the rehab has to match the surgery. ROM targets, strengthening timelines, and long-term expectations are completely different between the two. At Forward, we built our Return+ shoulder protocol around the latest evidence for both approaches.
Return+ Shoulder Protocol
Seven phases from post-op through one year. Early phases focus on passive and assisted ROM within surgeon-specified limits. As tissue heals, we transition to active motion, then progressive strengthening with objective measurement. For reverse TSA, we respect the altered biomechanics — adjusted rotation limits, softened strength thresholds, and realistic targets based on published outcomes.
What We Measure
- Shoulder ROM — four-plane measurement with PROM-to-AROM tracking
- Strength — isometric force early, HHD with LSI later
- ASES — American Shoulder and Elbow Surgeons score
- QuickDASH — upper extremity function
- Pain monitoring — phase-appropriate thresholds
Different Surgery, Different Expectations
aTSA patients typically achieve higher rotational strength and ROM. rTSA patients follow a more conservative progression but gain meaningful improvements in overhead function. Research shows rTSA external rotation strength continues improving through year two. We set expectations based on evidence, not hope — and we track progress to prove it.