Reverse shoulder replacement surgery offers a solution for individuals with specific shoulder conditions, such as severe rotator cuff tears or arthritis, where traditional shoulder replacement is not suitable. This procedure involves reversing the natural ball-and-socket anatomy of the shoulder to allow other muscles, like the deltoid, to power arm movement. The recovery process is a structured journey to regaining function and reducing pain.
Immediately After Surgery
Immediately following reverse shoulder replacement surgery, patients are moved to a recovery room for close monitoring as anesthesia wears off. Discomfort is expected. To manage this, prescription pain medication, including opioids and non-steroidal anti-inflammatory drugs (NSAIDs), is typically administered. Nerve blocks may also provide effective pain relief for the first day.
A sling is applied immediately after surgery and worn consistently, often for 4 to 6 weeks, even during sleep. This device protects the new joint, maintains proper positioning, and minimizes accidental movements. Wound care is a priority; the incision site must be kept clean and dry. Avoid submerging the wound; pat it dry after showering, which may be permitted after a few days or weeks.
Early, gentle movements for the hand, wrist, and elbow prevent stiffness and promote circulation. While the shoulder remains immobilized, activities like bending and straightening the elbow, hand squeezes, and gentle neck stretches start within days. Patients may find it more comfortable to sleep in a recliner or a slightly elevated position to reduce pressure on the shoulder.
The First Few Months of Recovery
The first few months involve focused physical therapy and gradual progression. Around 6 to 12 weeks post-surgery, patients can stop using the sling and begin more active rehabilitation. Physical therapy sessions, starting within the first two weeks, help regain range of motion and build strength. Early exercises include passive range-of-motion activities and pendulum exercises.
As healing progresses, exercises become more active, focusing on improving deltoid and shoulder blade muscle function. Gradually increase the shoulder’s flexibility, stability, and strength for more complex movements. Continue pain management at home with medication and ice therapy to reduce swelling and discomfort.
Modify daily activities during this phase. Avoid pushing down on the operated arm to get out of a chair, or reaching behind the back. Consistency with prescribed exercises and activity precautions is vital for successful recovery.
Long-Term Rehabilitation and Lifestyle
Beyond the initial few months (3 to 6 months post-surgery), rehabilitation focuses on building strength and coordination. Physical therapy progresses to advanced exercises targeting the deltoid and periscapular muscles. These exercises involve light weights, resistance bands, and movements mimicking daily tasks. Strength and movement can continue to improve for up to two years.
Gradual return to activities like driving, light chores, and hobbies is permitted once sufficient strength and control are achieved. Non-contact and low-impact sports, such as golf or swimming, may be resumed around 5 to 6 months with adequate strength and range of motion. Permanent restrictions on certain activities apply to protect the new joint.
Lifting restrictions are common; patients are advised not to lift more than 25 pounds, particularly above chest level. Certain movements, like extreme rotation or reaching directly behind the back, may remain limited to reduce dislocation risk. Long-term shoulder health involves a home exercise program and regular follow-up appointments with the orthopedic surgeon.
When to Seek Medical Attention
Know when to seek medical attention. Infection signs include increased redness, unusual warmth, swelling, or drainage of pus or fluid around the incision site. Fever greater than 100.4°F and chills also indicate infection.
Report sudden, severe pain not relieved by medication, or a significant increase in pain after initial improvement. Numbness or tingling, or significant swelling in the arm or hand, could indicate nerve or circulation issues. A sudden “clunk” sensation in the shoulder, with inability to move the arm, suggests implant dislocation. These symptoms require immediate contact with your healthcare provider.