Anatomic (Conventional) Shoulder Replacement

The recovery process

Rehabilitation after anatomic shoulder replacement is a gradual, structured process designed to restore movement and strength without damage to the replacement in the early stages. Your program will be directed by Dr. Dallalana based on the following outline and guided by your physiotherapist through to completion.

General guidelines

FIRST 6 WEEKS

Sling

A sling is needed for the first 6 weeks. Unless advised otherwise the sling is not needed when sedentary in the home, nor in bed at night. Use the sling provided when walking out of the home, or within the home only when walking for any extended period e.g. around the garden. The sling can be removed in this time period and both hands used freely to write, type, eat and assist with dressing and personal hygiene.
The sling should be loose fitting, and no waist strap should be used
The sling is used to protect from excessive movement and use, from sudden reflex movement and from other people. It is not there to support the weight of the arm as such.

Reducing pain and swelling – icing is helpful within the first 2 weeks Pain levels are usually low by week 2, requiring simple analgesics, and the exercises become progressively easier.

Use of the arm

Simple daily tasks including desk work
Avoid lifting any heavy items or forceful pushing or pulling with the affected side
Movements are restricted and forceful use discouraged in the first 6 weeks to protect the subscapularis muscle repair - this is a part of the rotator cuff group of muscles at the front of the shoulder. It is cut to allow access and then repaired with internal stitches at the end of the replacement procedure. Protection of this muscle repair is important in the long-term success of the anatomic shoulder replacement
You cannot drive a vehicle in this time

Exercises

Maintaining mobility in the elbow, wrist, and hand
Scapular setting (posture) exercises
Perform the exercises shown at least 3 times per day at home, unless pain prevents this.
Progression of active-assisted exercises (helping move your arm using your other arm or equipment such as a stick or pulley)

Your sling is discontinued after 6 weeks

6 TO 12 WEEKS

Weeks 6–9: Expanding movement and light strength

This phase includes:

Formal physiotherapy sessions beginning at 6 weeks to guide and advance exercises and optimise the final outcome
Increased range of motion in all directions, including gradual external rotation (rotation outwards to the side), to maximum extent. No movement range restrictions apply at this stage
Rotation behind the back (internal rotation) may be commenced, and is expected to be a little uncomfortable initially
Light strengthening of the shoulder muscles – Isometric contraction exercises
More active use of the arm in daily activities

Driving is resumed during this stage.

Weeks 9–12: Building strength and control

Continue regular physiotherapy visits and 3 x daily exercises at home

BEYOND 12 WEEKS

3 to 6 Months: Advanced recovery

Peak range of motion and strength is obtained by 12 months, occasionally up to 2 years for some muscles. Formal physiotherapy can cease between 4 and 6 months after surgery depending on progress, however ongoing home exercising is useful to derive maximum benefit.

Your rehabilitation journey

Recovery timelines can vary depending on your muscle strength, general health, and participation in physiotherapy and home exercises. Recovery is gradual and following your rehabilitation program is important to ensure the best outcome.

Further information about return to activity is found on the page relating to anatomic shoulder replacement surgery

Can shoulder or elbow surgery help with ongoing pain?

In appropriate cases, modern orthopaedic techniques may help reduce pain, improve strength and mobility, and support a more active and confident lifestyle. Outcomes vary depending on your condition and individual circumstances.