Illustration note: The opening image shows a man holding an exercise wand, not a verified demonstration of a particular postoperative technique or recovery stage. The care-discussion image below is also illustrative, not a patient testimonial or evidence of clinical review of this article.
Reverse shoulder replacement exercises can include hand and wrist movement, assisted shoulder motion and, later, strengthening. The important difference is which movement your own surgical team has allowed, how it is supported and whether the operated shoulder supplies the effort.
This guide explains actual exercises in a hospital leaflet, then shows why its instructions cannot be combined with another hospital’s timetable. It also puts the day-26 recovery diary that prompted this article beside controlled research, rather than treating that date as a recovery target.
Use your own postoperative instructions: These are descriptions of published care resources, not permission to start or advance rehabilitation. Ask your treating therapist to demonstrate any prescribed movement and record your individual limits, repetitions and frequency.
What Changes After a Reverse Replacement?
A reverse replacement switches the positions of the shoulder’s ball and socket. The American Academy of Orthopaedic Surgeons explains that the design relies on the deltoid to power and position the arm when the rotator cuff cannot function normally.
Reasons for surgery include damaged cuff tendons, arthritis, fractures and failed previous surgery. Those are different starting points, so the word reverse alone does not describe every repair that rehabilitation must protect.
A useful exercise explanation therefore needs more than a movement name. It needs the starting position, the permitted range, the source of assistance and the type of effort.
Understand the Movement Words on Your Exercise Sheet
The same arm movement can be performed in different ways. Raising an arm with help is not automatically the same task as lifting it independently or lifting against resistance.
| Term | What it describes | Detail to confirm |
|---|---|---|
| Passive movement | The shoulder is moved without deliberately powering the movement with its own muscles. | Who or what moves the arm? |
| Assisted movement | Another hand or an aid helps the movement. | How much effort should the operated side contribute? |
| Active movement | The operated arm performs the movement using its muscles. | Is independent lifting allowed? |
| Resistance exercise | Muscles work against an opposing force. | Is resistance allowed, and of what kind? |
A stick, pulley or wall does not answer those questions by itself. The aid may assist a movement, but its presence is not proof that an exercise is passive or appropriate at your stage.
Have the therapist mark the exact version on your sheet. A sketch or a demonstration of your prescribed position is more useful than an unexplained instruction to do shoulder exercises.
Three Shoulder Exercises Described in One Hospital Leaflet
University Hospitals Birmingham’s reverse-replacement leaflet describes the following movements. These selected examples belong to that leaflet; use them only if they match the exercises your treating team has already assigned.
- Pendulum: Lean forward, supported on the non-operated arm, and let the operated arm swing forward and backward.
- Assisted flexion with a stick: Lie on your back, hands touching on the stick with palms down. Raise it with straight arms, letting the non-operated arm do most of the work while the operated arm stays relaxed, then return.
- Assisted outward rotation: Lie on your back with a folded towel under the operated upper arm and the elbow bent to 90 degrees. Keep the elbow close to your body and use the stick to assist outward rotation, then return.
For the stick movements, the leaflet says not to force movement or produce a stretch. Its default is 10 repetitions, three times daily, unless the physiotherapist advises otherwise; this is a source description, not a dose chosen for you.
Read the complete hospital leaflet and its figures alongside your own written plan. A brief description cannot show a therapist’s individual adjustment of your position or assistance.
The distinction matters for the opening photograph: a person standing with a wand is not a substitute for the leaflet’s lying-down setup. Neither the photograph nor the diary establishes which position is cleared for another patient.
Even Elbow Movement Can Have a Surgical Exception
The Royal National Orthopaedic Hospital’s reverse-replacement guide includes finger and wrist movement, and forearm rotation with the arm in its sling. Its separate assisted-elbow exercise uses the other hand to help bend and straighten the operated arm.
The same guide warns that a biceps tenodesis changes the instructions: patients must not actively bend the elbow or fully straighten it while that repair is being protected. This is why a general instruction to keep your elbow moving needs the operation-specific exception beside it.
Its reverse-replacement guide and illustrations require therapist instruction before starting the listed exercises. Do not use an ordinary elbow-mobility routine to override that restriction.
A clear handover should tell you whether the elbow moves actively, with assistance or within a restricted range. If that detail is missing, ask for it before improvising with an otherwise familiar movement.
Why the Published Calendars Cannot Be Combined
Different instructions may each belong to a particular service’s pathway. Taking an early starting date from one leaflet and a more demanding exercise from another creates a new program that neither source assessed.
| Source | Published boundary | Meaning for the reader |
|---|---|---|
| Knee and Shoulder Clinic, Dr. Macgroarty’s protocol | The first stage runs from day one to week six and specifies no active movement of the operated arm. | The document applies to that surgeon’s patients and says physician precautions take precedence. |
| Royal National Orthopaedic Hospital | Its initial restrictions include no active operated-arm use and no weight bearing, such as pushing up from a chair. | A familiar daily task can load the shoulder even when it is not called an exercise. |
| BSR Physical Therapy’s strengthening article | It places light strengthening at six to eight weeks in its described recovery pathway. | A later strengthening example is not evidence that the same movement belongs in a day-26 routine. |
AAOS similarly advises following the prescribed home program and avoiding forceful pushing from a chair or bed. Its general advice does not replace a surgeon’s different restrictions.
Keep the exercise and its conditions together when reading a source. A repetition count without the permitted starting position, assistance and timing is an incomplete instruction.
What Early Versus Delayed Rehabilitation Research Shows
Hagen and colleagues randomized patients to immediate physical therapy for passive and active motion or no shoulder range of motion for six weeks. The trial enrolled 107 shoulders; 86 completed one-year follow-up, comprising 42 in immediate therapy and 44 in delayed therapy.
Both groups improved, with no significant between-group difference for most postoperative measures. One six-month functional score favored delayed therapy, and the abstract reported no difference in complications.
That result supports studying more than one rehabilitation approach, not declaring every early exercise equally safe. A nonsignificant complication comparison also cannot guarantee that a movement has no risk for an individual.
A 2025 review specifically examined nonfracture reverse replacements. Its six studies included 1,763 patients, with modest motion differences below the clinical threshold the authors discussed and no detected difference in dislocation or revision.
Fracture-related surgery is outside that review’s stated scope. Its pooled results therefore cannot clear a fracture patient to borrow another person’s early routine.
The timing question is a clinical comparison between defined pathways. It does not tell a viewer which exercise to add after watching a recovery update.
What the Day-26 Diary Adds, and What It Cannot Establish
Motorhoming Fun’s public description lists stick-assisted work, shoulder rotation, pulleys, elbow mobility and hand or wrist movement. The creator reports following a physiotherapy program and advises viewers to follow their own surgeon and physiotherapist.
Those are the creator’s reported circumstances, not independently verified clearance for the filmed movements. The retained video is personal recovery context, not the source of the exercise instructions above.
A diary can make the daily work of recovery feel less abstract. It cannot show that copying the same list causes the same result, or that every viewer had the same repair.
A descriptive study following one staged protocol cannot, without an appropriate comparison, establish that its structure beats another program. It can describe what happened under that pathway, which is a different question.
The cited electrical-stimulation home-exercise follow-up began its intervention one year after surgery and re-examined only 10 intervention participants. It does not validate the first month’s home exercises or the diary’s day-26 list.
Make Your Own Exercise Instructions Usable
Bring your actual discharge sheet and any exercise you do not understand to the next discussion. Ask the therapist to fill in the missing instruction rather than asking whether all shoulder exercise is good or bad.
- Position: Lying down, sitting or standing, with which part supported?
- Assistance: Which hand or aid supplies the movement, and how much effort comes from the operated arm?
- Range: Where does the movement stop, including any elbow or rotation restriction?
- Amount: Which repetitions and daily frequency are written for this exact exercise?
- Progression: Who changes the instruction, and at which review?
This record is an aid to understanding prescribed care, not a self-clearance test. Do not add resistance, discard a sling or copy a later-stage movement because a date on someone else’s calendar matches yours.
Use the contact instructions supplied by your surgical service for new pain, swelling, instability or concerns about the wound. A page or video cannot determine whether a postoperative change is expected or needs assessment.
The practical answer is to understand the exact exercises already assigned to you, including their assistance and restrictions. Published resources help explain those terms, while the surgical details determine which version belongs in your recovery.
References
American Academy of Orthopaedic Surgeons. Reverse total shoulder replacement. OrthoInfo.
University Hospitals Birmingham. Reverse shoulder replacement: Patient information. Exercise instructions, pages 6 and 7.
Royal National Orthopaedic Hospital. Reverse-type total shoulder replacement: Patient guide. Exercises and therapy section.
Knee and Shoulder Clinic. Reverse total shoulder replacement rehabilitation guidelines. Dr. Macgroarty’s patient protocol.
BSR Physical Therapy. Reverse shoulder replacement recovery: Strengthening exercises. November 11, 2020.
Hagen, M. S., et al. (2020). Early rehabilitation versus immobilization after reverse total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery, 29, 442 to 450.
Thamrongskulsiri, N., et al. (2025). Early mobilisation versus delayed protocols for nonfracture indications. Journal of Experimental Orthopaedics. DOI: 10.1002/jeo2.70449.
Wittmann, T., et al. (2026). Long-term follow-up of electrical-stimulation-augmented home exercise. JSES International. DOI: 10.1016/j.jseint.2026.101744.
Watch the Original Recovery Diary
The source below is retained for context, not as a substitute for postoperative instructions. Its public description was reviewed; the complete movement sequence and spoken instructions were not independently verified.
View the original recovery diary on YouTube if the embedded player does not load.
Medical disclaimer: This article provides general information about postoperative shoulder exercises, not an individual rehabilitation plan or medical advice. Follow your surgeon and physiotherapist’s instructions, and consult them before changing exercises, loading or restrictions after surgery.
