Revision Total Shoulder Arthroplasty (Both Components) — Complete Exercise Program

Pendulum Swings

Gentle, relaxed swinging that eases the shoulder into motion without the muscles having to work.

What it helps: Coaxes the shoulder through gentle motion with the muscles relaxed — keeping the joint moving and easing stiffness when active movement is still uncomfortable.

1. Lean forward and support your good arm on a table or chair, letting the sore arm hang down relaxed.
2. Let the arm swing gently — small circles, then forward-and-back and side-to-side — using a gentle sway of your body, not the shoulder muscles.
3. Keep it loose and pain-free, like a relaxed pendulum.

Tips:

• The movement comes from rocking your body, not from working the shoulder.
• Keep the swings small and comfortable.

Commonly done as 2–3 sets of 1–2 min, a few times a day.

Scapular Retraction

Gentle shoulder-blade squeezes — safe immediately, because the shoulder joint itself does not move.

What it helps: Keeps the muscles that position the shoulder blade working while the shoulder joint itself is resting. Those muscles set the platform the whole shoulder moves on, and they weaken quickly in a sling, which makes the later recovery harder than it needs to be.

1. Sit or stand tall with your arms resting at your sides or supported in the sling.
2. Draw both shoulder blades gently back and down, as though squeezing them toward each other.
3. Keep the movement small and slow. Your arms should not move at all.
4. Hold briefly, then relax completely.

Tips:

• Small is correct. This is a squeeze between the shoulder blades, not a shrug and not an arm movement.
• Because the shoulder joint stays still, this is usually allowed from the first days — check with your care team if unsure.
• Easy to do sitting at a desk or watching television, several short sets through the day.

Commonly done as 2–3 sets of hold 5s, 10 times, daily.

Elbow Range of Motion

Gentle bending, straightening, and forearm turning to keep the elbow moving freely.

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tips:

• Keep the upper arm still — the movement is at the elbow and forearm.
• Sore is okay; sharp is a sign to ease back.

Commonly done as 2–3 sets of 10 each, daily.

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Arm Nerve Glides

Gentle movements that help a neck nerve slide freely down the arm.

What it helps: Helps an irritated neck nerve glide freely down the arm, which can ease arm pain, tingling, or numbness. Gentle, repeated motion — never forced.

1. Sit or stand tall. Start with the affected arm out to the side, elbow bent, palm up.
2. Slowly straighten the elbow and ease the arm out while gently tilting your head AWAY — then return as you tilt the head back toward that side.
3. Move smoothly in and out of the range, like flossing — never holding at the end or pushing into symptoms.

Tips:

• Gentle is the rule — ease back the moment it provokes sharp or shooting arm symptoms.
• Small, smooth, repeated movements — not a hard stretch.
• Stop and check with your care team if symptoms steadily worsen.

Commonly done as 2–3 times sets of 10–15 slow glides, daily.

Gentle Neck Isometrics

A steady, held press against your own hand — strengthens the neck with no movement.

What it helps: Strengthens the deep muscles that support and steady your neck without moving it — a safe, comfortable way to build the support that eases neck pain.

1. Sit tall with a gentle chin-tuck. Place your palm on your forehead.
2. Press your head lightly into your hand and your hand back into your head — a steady, comfortable push with NO movement of the neck.
3. Hold, relax, and repeat. Do the same with the hand on the back of the head, then each side.

Tips:

• Light pressure — about 20–30% effort. This is not a strength test.
• No actual neck movement: the head stays still while the muscles work.
• Keep the gentle chin-tuck throughout.

Commonly done as 5 each direction sets of Hold 5–10 seconds, daily.

Upper Trap & Levator Stretch

Eases tension in the muscles that run from the neck to the shoulder.

What it helps: Loosens the tight neck-to-shoulder muscles that often build up tension and pull on the neck, easing stiffness and discomfort.

1. Sit or stand tall. Gently tip one ear toward that shoulder until you feel a comfortable stretch along the opposite side of the neck.
2. For the levator (back-corner of the neck), turn your nose toward your armpit and ease forward a little.
3. Rest the hand on that side gently behind your head for a touch more stretch — no pulling. Switch sides.

Tips:

• Gentle and comfortable — never force the neck.
• Keep the opposite shoulder relaxed down, not hiked up.

Commonly done as 2–3 each side sets of Hold 20–30 seconds, daily.

Core Activation

Gentle core engagement to support posture and balance while you recover.

What it helps: Switches on the deep core muscles that stabilize your pelvis and spine, giving your hips a solid platform to move from.

1. Lie or sit comfortably.
2. Gently draw your belly button toward your spine.
3. Hold a few seconds while breathing normally, then relax.

Tips:

• Avoid holding your breath.

Commonly done as 2-3 sets of 10, daily.

Walking Program

Short, frequent walks build endurance and confidence.

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Cane-Assisted Shoulder Flexion

Your good arm lifts the operated one with a stick, so the repaired tendon does no work.

What it helps: Keeps the shoulder moving while the repaired tendon is protected from doing any work. Movement in these early weeks is what prevents the stiffness that is otherwise the hardest part of the recovery to undo.

1. Lie on your back holding a broom handle, walking stick or length of dowel across your body with both hands, palms up.
2. Keep the operated arm completely relaxed — let it be carried.
3. Use the good arm to push the stick, raising both arms up over your chest and toward your head.
4. Go only as far as is comfortable and as far as your surgeon has allowed, then lower slowly using the good arm to control it.

Tips:

• The operated arm is a passenger. If its muscles are working, the exercise is not doing its job.
• Lying down is easier than sitting or standing, because gravity is not fighting you and the arm relaxes more completely.
• Doing this after a warm shower, or after pain relief has taken effect, usually makes it easier.

Commonly done as 2–3 sets of 10–15, daily.

Cane-Assisted External Rotation

Passive turning of the arm outward, powered entirely by the good arm.

What it helps: Preserves the outward rotation of the shoulder, which is the movement most commonly lost after a rotator cuff repair and the hardest to regain once it has gone. Doing it passively means the repair is not loaded.

1. Lie on your back or sit with the operated elbow tucked against your side, bent to a right angle. A rolled towel between elbow and body helps.
2. Hold a stick across your body with both hands.
3. Keeping the elbow against your side, use the good arm to push the stick so the operated forearm rotates outward, away from your stomach.
4. Go only to the limit your surgeon has set, hold briefly, then let the good arm bring it back.

Tips:

• The elbow stays glued to your side. Letting it drift away from the body turns this into a different, less useful movement.
• Your surgeon may have set a specific limit on how far out to go — that limit protects the repair and is worth following exactly.
• Keep the operated arm relaxed throughout; the good arm is doing all of the work.

Commonly done as 2–3 sets of 10–15, daily.

Wall Walks (Finger Walks)

Walking the fingers up a wall to gradually regain overhead reach.

What it helps: Gradually rebuilds overhead reach with the wall sharing the arm's weight — a gentle way to recover motion when lifting the arm freely is still hard.

1. Stand facing a wall, fingertips on it at about waist height.
2. Slowly "walk" your fingers up the wall, letting the shoulder lift the arm as high as is comfortable.
3. Walk back down with control. Turn side-on to the wall to work the outward direction too.

Tips:

• Let the wall support the arm's weight — that's the point.
• Go only as high as comfortable; a little higher each week.

Commonly done as 2 sets of 5–10, daily.

Scapular Retraction

Gentle shoulder-blade squeezes — safe immediately, because the shoulder joint itself does not move.

What it helps: Keeps the muscles that position the shoulder blade working while the shoulder joint itself is resting. Those muscles set the platform the whole shoulder moves on, and they weaken quickly in a sling, which makes the later recovery harder than it needs to be.

1. Sit or stand tall with your arms resting at your sides or supported in the sling.
2. Draw both shoulder blades gently back and down, as though squeezing them toward each other.
3. Keep the movement small and slow. Your arms should not move at all.
4. Hold briefly, then relax completely.

Tips:

• Small is correct. This is a squeeze between the shoulder blades, not a shrug and not an arm movement.
• Because the shoulder joint stays still, this is usually allowed from the first days — check with your care team if unsure.
• Easy to do sitting at a desk or watching television, several short sets through the day.

Commonly done as 2–3 sets of hold 5s, 10 times, daily.

Arm Nerve Glides

Gentle movements that help a neck nerve slide freely down the arm.

What it helps: Helps an irritated neck nerve glide freely down the arm, which can ease arm pain, tingling, or numbness. Gentle, repeated motion — never forced.

1. Sit or stand tall. Start with the affected arm out to the side, elbow bent, palm up.
2. Slowly straighten the elbow and ease the arm out while gently tilting your head AWAY — then return as you tilt the head back toward that side.
3. Move smoothly in and out of the range, like flossing — never holding at the end or pushing into symptoms.

Tips:

• Gentle is the rule — ease back the moment it provokes sharp or shooting arm symptoms.
• Small, smooth, repeated movements — not a hard stretch.
• Stop and check with your care team if symptoms steadily worsen.

Commonly done as 2–3 times sets of 10–15 slow glides, daily.

Shoulder Isometrics

Gentle no-movement holds that switch on the shoulder muscles without straining the joint.

What it helps: Activates and strengthens the shoulder muscles with gentle static holds — a comfortable way to build strength early, before the joint is ready for moving resistance.

1. Stand near a wall or door frame. For external rotation: elbow bent and tucked, press the back of your hand/forearm gently into the wall and hold — no movement.
2. For abduction: press the outside of your arm into the wall. For flexion: press the front of your fist into the wall.
3. Use light, comfortable pressure, hold steadily, then relax.

Tips:

• No movement happens — you're gently pressing against something solid.
• Start at about a quarter effort; never push into pain.

Commonly done as 2 sets of Hold 5–10 sec ×5, most days.

Cross-Body Shoulder Stretch

A simple stretch for the back and outside of the shoulder.

What it helps: Stretches the back and outer shoulder, easing tightness that limits reaching across the body.

1. Bring the affected arm straight across the front of your body at about chest height.
2. Use your other hand to gently draw it closer across your chest until you feel a comfortable stretch in the back of the shoulder.
3. Hold, then release.

Tips:

• Keep your shoulder down and relaxed — don't shrug it up.
• Gentle and steady.

Commonly done as 3 sets of Hold 20–30 sec, daily.

Doorway Chest Stretch

Opens the chest to counter a rounded, forward posture.

What it helps: Tight chest muscles round the shoulders and push the head forward, loading the neck. Opening them up helps you sit and stand tall, taking strain off the neck.

1. Stand in a doorway with your forearms resting on the frame, elbows about shoulder height.
2. Step one foot through and let your chest ease gently forward until you feel a comfortable stretch across the front of the chest and shoulders.
3. Hold, breathing easily, then step back.

Tips:

• Keep it comfortable — you should feel a stretch, not a strain.
• Stand tall; don't let the low back arch to chase the stretch.

Commonly done as 2–3 times sets of Hold 20–30 seconds, daily.

Stationary Bike

Builds motion and endurance with low impact.

What it helps: Keeps the joints moving and nourished while you build endurance — all with no pounding. One of the gentlest ways to stay active when a joint is sore.

1. Set the seat so pedaling is comfortable.
2. Pedal at an easy pace.
3. Increase your time gradually.

Commonly done as directed.

Wall Walks (Finger Walks)

Walking the fingers up a wall to gradually regain overhead reach.

What it helps: Gradually rebuilds overhead reach with the wall sharing the arm's weight — a gentle way to recover motion when lifting the arm freely is still hard.

1. Stand facing a wall, fingertips on it at about waist height.
2. Slowly "walk" your fingers up the wall, letting the shoulder lift the arm as high as is comfortable.
3. Walk back down with control. Turn side-on to the wall to work the outward direction too.

Tips:

• Let the wall support the arm's weight — that's the point.
• Go only as high as comfortable; a little higher each week.

Commonly done as 2 sets of 5–10, daily.

Scaption Raises

Light raises in the shoulder's natural plane that build the cuff and deltoid safely.

What it helps: Strengthens the rotator cuff and shoulder muscles through a raise in the joint's most comfortable plane — building overhead strength while keeping the shoulder clear of pinching.

1. Stand with arms at your sides, thumbs pointing up.
2. Raise both arms out and slightly forward — about 30° from straight ahead (the "scapular plane"), like a shallow Y.
3. Lift to shoulder height or to just before any pinch, then lower slowly.

Tips:

• Thumbs up, slight forward angle — the shoulder's safest, roomiest position.
• Start with no weight; add a light weight only when it stays comfortable. Stop below any painful pinch.

Commonly done as 2 sets of 8–12, most days.

Shoulder Isometrics

Gentle no-movement holds that switch on the shoulder muscles without straining the joint.

What it helps: Activates and strengthens the shoulder muscles with gentle static holds — a comfortable way to build strength early, before the joint is ready for moving resistance.

1. Stand near a wall or door frame. For external rotation: elbow bent and tucked, press the back of your hand/forearm gently into the wall and hold — no movement.
2. For abduction: press the outside of your arm into the wall. For flexion: press the front of your fist into the wall.
3. Use light, comfortable pressure, hold steadily, then relax.

Tips:

• No movement happens — you're gently pressing against something solid.
• Start at about a quarter effort; never push into pain.

Commonly done as 2 sets of Hold 5–10 sec ×5, most days.

Scapular Y-T-W

Strengthens the muscles between and around the shoulder blades.

What it helps: Builds the mid-back and shoulder-blade muscles that anchor and position the shoulder — the foundation that lets it move and lift without pinching.

1. Lie face-down (or bend forward at a table) with arms hanging.
2. Y: raise both arms overhead into a Y, thumbs up, squeezing the shoulder blades. Lower.
3. T: raise arms straight out to the sides into a T. W: bend elbows and pull them down and back into a W, squeezing the blades. Move through each with control.

Tips:

• Lead with squeezing the shoulder blades, not shrugging.
• Light or no weight; quality over quantity.

Commonly done as 2 sets of 8–10 each, a few times a week.

Rhythmic Stabilization

Quick, gentle holds against light pushes that train the shoulder to stay stable and controlled.

What it helps: Trains the shoulder's stabilizing muscles to react and hold the joint steady — building the dynamic control that keeps the shoulder secure during everyday movement.

1. Hold the arm in a comfortable position (e.g., in front, elbow slightly bent). Have a partner or your other hand apply light, quick pushes from different directions.
2. Resist just enough to keep the arm steady — small holds, not big movements.
3. Progress to a hand on a wall or ball, gently shifting weight through the arm.

Tips:

• The arm barely moves — you're reacting to keep it still.
• Light and controlled; this is about control, not strength.

Commonly done as 2–3 sets of 30–60 sec, most days.

Sleeper Stretch

Stretches the back of the shoulder capsule, which is often tight and limits motion.

What it helps: Loosens the back of the shoulder capsule, which commonly tightens and restricts reaching — restoring smooth motion and easing the pinch at the front of the shoulder.

1. Lie on your side on the affected shoulder, arm out in front, elbow bent 90° so the forearm points up.
2. With your other hand, gently press the forearm down toward the bed, feeling a stretch in the back of the shoulder.
3. Hold the gentle stretch; don't force it.

Tips:

• Roll slightly back off the shoulder so you're not crushing it.
• A gentle, steady stretch — never sharp.

Commonly done as 3 sets of Hold 20–30 sec, daily.

Core Strengthening

Supports posture and overall stability.

What it helps: Builds the core that holds your trunk steady, supporting your posture, your back, and everything you do on your feet.

1. Perform gentle core exercises as directed.

Commonly done a few times a week.

Walking Program

Short, frequent walks build endurance and confidence.

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Swimming

Low-impact, full-body conditioning.

What it helps: Full-body conditioning with the water carrying your weight, so your muscles work hard with almost no load on the joints.

Commonly done as able.

Progressive Strengthening

Gradually increases strength as you recover.

What it helps: Gradually raises the challenge as you get stronger, so your body keeps adapting and improving rather than plateauing.

Commonly done as directed.

Scapular Y-T-W

Strengthens the muscles between and around the shoulder blades.

What it helps: Builds the mid-back and shoulder-blade muscles that anchor and position the shoulder — the foundation that lets it move and lift without pinching.

1. Lie face-down (or bend forward at a table) with arms hanging.
2. Y: raise both arms overhead into a Y, thumbs up, squeezing the shoulder blades. Lower.
3. T: raise arms straight out to the sides into a T. W: bend elbows and pull them down and back into a W, squeezing the blades. Move through each with control.

Tips:

• Lead with squeezing the shoulder blades, not shrugging.
• Light or no weight; quality over quantity.

Commonly done as 2 sets of 8–10 each, a few times a week.

Scaption Raises

Light raises in the shoulder's natural plane that build the cuff and deltoid safely.

What it helps: Strengthens the rotator cuff and shoulder muscles through a raise in the joint's most comfortable plane — building overhead strength while keeping the shoulder clear of pinching.

1. Stand with arms at your sides, thumbs pointing up.
2. Raise both arms out and slightly forward — about 30° from straight ahead (the "scapular plane"), like a shallow Y.
3. Lift to shoulder height or to just before any pinch, then lower slowly.

Tips:

• Thumbs up, slight forward angle — the shoulder's safest, roomiest position.
• Start with no weight; add a light weight only when it stays comfortable. Stop below any painful pinch.

Commonly done as 2 sets of 8–12, most days.

Rhythmic Stabilization

Quick, gentle holds against light pushes that train the shoulder to stay stable and controlled.

What it helps: Trains the shoulder's stabilizing muscles to react and hold the joint steady — building the dynamic control that keeps the shoulder secure during everyday movement.

1. Hold the arm in a comfortable position (e.g., in front, elbow slightly bent). Have a partner or your other hand apply light, quick pushes from different directions.
2. Resist just enough to keep the arm steady — small holds, not big movements.
3. Progress to a hand on a wall or ball, gently shifting weight through the arm.

Tips:

• The arm barely moves — you're reacting to keep it still.
• Light and controlled; this is about control, not strength.

Commonly done as 2–3 sets of 30–60 sec, most days.

Rowing Machine

Low-impact, full-body conditioning.

What it helps: Full-body, low-impact conditioning that builds strength and stamina without pounding the joints.

Commonly done as able.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Using light hand weights or a resistance band while seated, work through gentle arm and shoulder movements.

Tips:

• Stay seated and supported while you're non-weight-bearing.

Commonly done a few times a week.

Functional Strength Training

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
2. Add resistance gradually.

Tips:

• Quality of movement first, then load.

Commonly done several times a week.

Cycling

Low-impact endurance and motion.

What it helps: Low-impact endurance that keeps the joints moving smoothly while you build fitness — easy on the body, good for the long run.

Commonly done as able.

Flexibility Exercises

Maintains a comfortable range of motion.

What it helps: Keeps your joints and muscles moving through a comfortable range, so you stay supple and move with ease.

Commonly done most days.

Strength Training

Maintains and builds long-term strength.

What it helps: Builds and maintains long-term strength to keep you active, resilient, and independent.

Commonly done a few times a week.

Low-Impact Recreational Activities

Enjoyable activities that protect your joint.

What it helps: Getting back to the activities you enjoy in ways that are kind to your joints — the whole point of building this strength.

Commonly done as you like.

Functional Strength Training

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
2. Add resistance gradually.

Tips:

• Quality of movement first, then load.

Commonly done several times a week.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Using light hand weights or a resistance band while seated, work through gentle arm and shoulder movements.

Tips:

• Stay seated and supported while you're non-weight-bearing.

Commonly done a few times a week.

Swimming

Low-impact, full-body conditioning.

What it helps: Full-body conditioning with the water carrying your weight, so your muscles work hard with almost no load on the joints.

Commonly done as able.

Walking Program

Short, frequent walks build endurance and confidence.

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Balance Exercises

General balance work to steady your gait.

What it helps: Steadies your gait and sharpens your balance, helping you move with confidence.

1. Practice standing balance near support.
2. Progress as you feel steady.

Commonly done daily.

Flexibility Exercises

Maintains a comfortable range of motion.

What it helps: Keeps your joints and muscles moving through a comfortable range, so you stay supple and move with ease.

Commonly done most days.