The axillary nerve (AXN) innervates the deltoid and teres minor muscles. These muscles contribute to shoulder abduction, flexion, extension, and external rotation, all of which are necessary when performing reaching activities, such as grooming, showering, and household management. Axonal injury to the axillary nerve or an injury to the upper trunk of the brachial plexus (cervical roots 5 and 6) will result in loss of shoulder function. Surgical reconstruction options for the restoration of AXN function may include the spinal accessory nerve (SAN) to AXN transfer. This transfer uses all or part of a lower branch of the SAN that is responsible for scapular retraction, rotation, and depression, so the donor results in a synergistic motor pattern for the recipient deltoid muscle. Motor reeducation begins within the first month and follows the donor activation focused rehabilitation approach (DAFRA) to nerve transfers. Phase 1 emphasizes restoration of joint range of motion, patient education, and donor activation. It may take 6–9 months before a muscle twitch is appreciated in the deltoid muscle. This denotes the transition to phase 2. The second phase of rehabilitation focuses on gaining active control of the deltoid in gravity-lessened planes with co-contraction of the donor. When able, resistance exercises are added to the exercise program in phase 3. The literature suggests that not all patients will achieve more than 3/5 muscle strength in the recipient deltoid muscle.