The question of when you can move your arm after shoulder surgery is entirely dependent on the specific procedure performed and the customized healing protocol your surgeon prescribes. A timeline that applies to one person with a simple arthroscopy may be dangerous for another recovering from a complex tendon repair. This article provides general educational information about the typical phases of recovery, but only your surgical team can provide the precise, medically-advised instructions for your rehabilitation.
The Critical Distinction Between Passive and Active Movement
The most fundamental concept in early shoulder rehabilitation is the difference between passive and active movement. Immediately following surgery, the repaired tissue (whether tendon, ligament, or labrum) is highly vulnerable. Any stress that pulls on the repair site can cause the healing tissue to fail.
Passive Range of Motion (PROM) is movement initiated by an outside force, such as a physical therapist, a pulley system, or your unaffected arm. This movement is typically allowed sooner because the muscles responsible for the repair are completely relaxed and not contracting. PROM helps prevent the shoulder joint capsule from becoming stiff without placing tension on the surgical repair.
Active Range of Motion (AROM) is movement generated solely by the contraction of your own shoulder muscles. AROM is strictly prohibited for a set period because muscle contraction pulls directly on the repaired structures, risking a re-tear or loosening of the fixation. The transition to active movement is a major milestone, signifying that the repaired tissue is sufficiently healed to withstand muscle tension.
Standardized Recovery Timelines Based on Surgery Type
Rotator Cuff Repair
Rotator cuff repair is one of the most restrictive surgeries because it involves reattaching tendon tissue to bone, a biological process that takes time to achieve sufficient strength. The initial phase focuses on protecting this tendon-to-bone interface and typically lasts about six to eight weeks. During this time, the arm is immobilized in a sling, and only passive range-of-motion exercises are permitted to prevent joint stiffness.
Active movement, which involves lifting the arm using your own muscles, is generally not permitted until eight weeks post-surgery. This delay ensures the biological healing of the tendon is strong enough to withstand the load of muscle contraction.
Shoulder Stabilization/Labral Repair
Repairing a torn labrum or stabilizing the shoulder joint (such as a Bankart or SLAP repair) requires a strict protection phase for soft tissue healing. Patients are usually in a sling for four to six weeks, and specific movements, particularly external rotation, are often limited. The initial goal is allowing the labrum to securely reattach to the bone without being pulled off by muscle tension.
Active range of motion is commonly introduced around the six-week mark, often beginning with active-assisted motion where the unaffected arm helps the surgical arm. Strengthening exercises typically begin later, at eight to twelve weeks, with a full return to high-demand activities requiring six months or more.
Simple Arthroscopy/Debridement
A simple arthroscopy, involving trimming frayed cartilage or removing loose bodies without repairing major tendons or ligaments, has an accelerated timeline. The immobilization period is short, often just a few days, with the sling used mainly for comfort. Since no major structure needs to heal to the bone, the risk of re-tear from early movement is minimal.
Patients are encouraged to begin passive and limited active range-of-motion exercises within the first week or two to prevent stiffness. The focus quickly shifts to strengthening, with many patients returning to light work within days and strenuous activities within two to three months.
Factors That Influence Your Personal Timeline
While standardized protocols provide a general framework, your personal recovery timeline is influenced by several biological and behavioral factors. The quality of the tissue being repaired is a major determinant; for example, a massive, retracted rotator cuff tear with poor tendon quality will require a longer and more cautious healing phase than a small, acute tear.
Individual health status significantly impacts the speed of tissue repair. Comorbidities such as diabetes or a history of smoking impede the blood flow and cellular processes necessary for optimal healing. Older patients also tend to experience a slower recovery rate compared to younger individuals.
Adherence to the prescribed physical therapy program is another factor influencing recovery. Consistent, correct execution of exercises within the allowed range prevents stiffness and promotes organized collagen formation at the repair site. Conversely, pushing the joint too hard or skipping sessions can lead to setbacks, including re-injury or the formation of restrictive scar tissue.
Recognizing Restricted Movements and Warning Signs
The ability to move the arm is highly restricted during the initial recovery phase to protect the surgical repair. Until specifically cleared by your surgeon or therapist, you must avoid lifting anything heavier than a coffee cup with the operative arm. Reaching away from the body or forcefully reaching behind the back should also be strictly avoided, as these motions place excessive strain on the healing structures. Movements that involve pushing off or bracing your weight with the operative arm, such as pushing yourself up out of a chair, are prohibited because they generate muscle forces that can compromise the repair.
While some pain and swelling are expected after surgery, certain symptoms warrant immediate medical attention. A sudden, sharp increase in pain not relieved by prescribed medication is a serious warning sign. Signs of infection must be reported without delay, including fever higher than 101°F, increased warmth, spreading redness around the incision, or yellowish discharge. New onset of numbness or tingling in the hand or fingers, or an audible popping or grinding sensation, should also prompt an immediate call, as these may indicate nerve irritation or failure of the surgical repair.