Shoulder Replacement Recovery

Shoulder replacement procedures are commonly performed as an outpatient, where you leave the surgical facility the same day. Occasionally, patients with severe medical conditions may require a brief observation stay for medical purposes at a hospital. The rapid recovery speaks to the improvements in the procedure, the anesthetic techniques, and the refined surgical execution by top shoulder specialists like Dr. Thomas Obermeyer.

The procedure itself is performed with a combination of a regional anesthetic (interscalene block) and light general anesthesia, where you are sleeping. The procedure is performed through a few inch-long incision in the front of the shoulder and takes approximately one hour. There are oral non-opioid medications given before the procedure, and a “cocktail” of numbing agents applied around the incision so you awaken with typically minimal complaints of discomfort. Once you are discharged, the sling holds your arm at your side and a prescription for a pain medication is made available at your pharmacy.

The sling is maintained day and at night for protection, however use of the hand is permitted for routine activities in front of the body, such as typing on a computer, using a cell phone, feeding oneself, and light food preparation. Sleeping for the first few weeks is best with the sling in place with the arm supported at your side with a pillow behind your elbow and sitting up slightly in a recliner. When you are comfortable going back to a standard bed lying on your back you can resume that as soon as you feel ready, commonly 2 to 3 weeks after surgery.

For activity, the key initially is to avoid forceful hand positioning in front and away from your body, to limit lifting to about the weight of a cup of coffee, and to avoid forcefully pushing yourself up or out of bed with the surgical arm. It is recommended you not bring the hand behind your back during the initial recovery process. The sling can be temporarily removed a couple times a day for hygiene (showering, starting at 5 days after surgery) as well as getting dressed (open shirts are ideal with the nonsurgical arm going through the sleeve first). Simple exercises can be initiated when you are comfortable around one week after surgery. Prescription pain medications are weaned after a few days and an anti-inflammatory or acetaminophen is recommended thereafter. You can resume driving at two weeks after surgery when you are comfortable, off pain medications, and feel confident doing so with use of the nonsurgical arm only(1).

Most patients are prescribed physical therapy starting around two weeks after surgery. The goals of therapy initially are for gentle movement of the replaced shoulder while not placing large loads on the arm. Before the sling is removed around 2-4 weeks, this can be done with pendulum, stick, and pulley exercises. After the sling is removed, you can resume reaching and using the arm for routine activities around the house and for daily function. The physical therapist plays an increasingly important role between 4 and 8 weeks for stretching your shoulder and initiating strengthening. Feedback is provided on your form and motion recovery, with home exercises are tailored to your specific case.

Around 10 to 12 weeks after surgery you can resume light physical recreational activities including golf for initially chipping and putting followed by a full swing and complete round between 4 and 5 months. As your motion and use of the arm continues to optimize at 5 to 6 months, overhead sporting like pickleball and freestyle swimming can be resumed. Heavy sporting activities including bowling is typically recommended at 5 to 6 months as your strength and motion normalizes. Pending your progress, there are benefits of light stretching and strengthening exercises a couple times a week past the 6 month mark following surgery to optimize your functional recovery.