The anatomic total shoulder arthroplasty is a challenge in modern physiotherapy: even if the rehabilitation itself is crucial to achieve a good functionality and can be harmful if managed unproperly, there are not so many surgical case histories, and guidelines are based on just few high-quality studies. The physiotherapist has to improve functionality and protect the healing tissues without accelerating the therapy beyond the patient’s ability or be too cautious, because the stiffness could became too tight to restore a good mobility. Therefore, the time-based protocols must be customized based on the patient’s need and the shoulder healing; the goals should be set up accordingly to the surgeon’s advice. The shoulder prosthesis rehabilitation begins before the surgical operation and could last over six months: the medical team and the patient should work together to make it successful. When this happens, the result can be very satisfying for the patient, who can return to an active, painless life.