Background Reverse total shoulder arthroplasty has been successful in patients suffering from advanced degenerative osteoarthritis with rotator cuff insufficiency. The currently practiced physical rehabilitation after a shoulder rehabilitation does not allow shoulder motion until 6 weeks post-operatively. These patients are required to be in a sling to assist the patient in immobilizing the operated shoulder. An accelerated rehabilitation with immediate active shoulder motion has not been studied in the setting of a revere total shoulder arthroplasty. Methods This is a single center and single surgeon operated, randomized controlled trial. The primary objective is to compare patient reported shoulder function using the American Shoulder and Elbow Society (ASES) score and shoulder range of motion in patients undergoing the traditional physical rehabilitation and accelerated shoulder rehabilitation post reverse total shoulder arthroplasty. Secondary outcomes will include the Simple Shoulder Test (SST) score, Patient Reported Outcome Information System (PROMIS) Global Health-10, radiological parameters and subscapularis tear on ultrasound. Discussion The study will assess the effectiveness of an accelerated shoulder rehabilitation with immediate active shoulder motion after a reverse total shoulder arthroplasty in patients with atraumatic osteoarthritis.