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Rehabilitation Tips
Surgery gives you a new joint, but rehabilitation gives you a new life. The best surgeon in the world cannot give you a functional shoulder if you do not participate in the recovery. The muscles around your shoulder have likely been weak and stiff for years due to arthritis. Retraining them takes time and effort.
Rehabilitation is a phased process. It starts with gentle, passive movements and progresses to active strengthening. Skipping steps can damage the repair process, whereas failing to engage in any activity can result in a “frozen,” stiff shoulder. This section provides a guide to the rehab journey, highlighting the exercises and habits that lead to the best outcomes.
Formal physical therapy (PT) usually begins a week or two after surgery. A physical therapist is your coach. They will guide you through the specific protocol your surgeon has chosen. They stretch your arm safely and teach you how to move without hiking your shoulder up (a common harmful habit).
Going to PT sessions is vital, but doing your home exercises on the “off” days is where the real progress happens. Consistency is key. Five minutes of stretching three times a day is better than one hour once a week.
In the first 6 weeks, the goal is flexibility without stress. You perform “passive” exercises, meaning the surgical muscles don’t do the work.
Pendulums: Lean forward and allow your arm to hang freely. Use your body’s momentum to gently swing the arm in circles. This keeps the joint loose. Table Slides: Place your hand on a table and slide it forward by leaning your body, stretching the arm without lifting it. Pulleys: Use a pulley system over a door. Your functioning arm pulls the rope to lift the surgical arm. This technique stretches the shoulder overhead safely.
Around week 6, the tendon is healed enough to start working. You begin “active-assist” exercises. You use a cane or your other hand to help lift the surgical arm.
You practice lifting the arm while lying on your back (supine flexion), which removes gravity and makes it easier. You also start “isometric” exercises—pushing your hand against a wall without moving. This wakes up the muscles without stressing the joint.
After 3 months, the focus shifts to strength. You will use resistance bands (Therabands) of increasing thickness.
External Rotation: Keep your elbow at your side and rotate your hand outward against the band. This strengthens the rotator cuff. Rows: Pull the band back, squeezing your shoulder blades together. This builds the foundation for the shoulder. Wall Push-ups: A gentle version of a push-up to build chest and shoulder strength.
Good posture is critical for a new shoulder. Slouching rolls the shoulders forward, which closes down the space in the joint and can cause pinching (impingement).
Focus on keeping your chest up and shoulder blades back. When you reach for something, turn your thumb up. Reaching with the thumb down puts the shoulder in a vulnerable position. Learn to lift objects close to your body rather than at arm’s length.
Maintaining your new shoulder requires long-term care. Continue to do basic stretches a few times a week to maintain flexibility.
Avoid “danger positions.” For a reverse shoulder, reaching behind your back (like tucking in a shirt) combined with internal rotation can risk dislocation. Use a reacher tool if needed. Avoid heavy overhead pressing at the gym. Listen to your shoulder; if it aches, rest and ice it.
Stiffness is common and expected. It is actually a sign that the soft tissues are healing tight, which provides stability. However, you must stretch it out to regain motion. It can take 6–12 months for the last bit of stiffness to resolve.
Ice is best for pain and inflammation. Heat can be used before stretching to loosen up the muscles but should not be used on a hot, swollen joint.
Initially, you should not lift anything heavier than a coffee cup. After three months, you might be able to lift up to 5-10 pounds. Long-term, most surgeons recommend limiting repetitive lifting to 25–40 pounds to preserve the implant’s lifespan.
You should avoid sleeping on the surgical side for at least 6 weeks to 3 months. Sleeping on the non-surgical side is fine if you place a pillow in front of your chest to rest your operated arm on.
Guidelines vary. Historically, patients with artificial joints took antibiotics before dental cleanings to prevent infection. Current guidelines are less strict, but many surgeons still recommend it for the first year or two. Ask your specific surgeon for their protocol.
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