Recovery time usually takes 4-8 months. The duration of your physical therapy plan of care will vary depending on a few variables including how well you are healing and what level of impairments existed prior to and following the surgery. A patient who was unable to use their arm much prior to their surgery may need a longer course of care than a patient who was able to maintain a relatively normal level of activity. While full return of function may take some time, you may begin to see some results right away. You should experience improvements in many symptoms such as pain, stiffness, and inflammation within a few weeks.

Progression in strength, flexibility and overall mobility that allows you to use the arm comfortably and in a more normal manner usually takes longer. Achieving long lasting results may take some time, but dedication to your program will help you achieve these results. Your PT will be able to give you a more specific timeline for recovery after your surgery and as you move through the rehabilitation process.

REVERSE TOTAL SHOULDER REPLACEMENT SURGERY

• Osteoarthritis
• Rheumatoid Arthritis
• Serious joint injuries (can lead to post-traumatic arthritis)
• Avascular necrosis
• Unstable or non healing fractures.

If you decide to work with a physical therapist to help with physical therapy for shoulder surgery issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

WHAT CAN I EXPECT FROM PHYSICAL THERAPY AFTER SURGERY?

Unlike some other joint replacement surgeries in which movement and use of the joint is recommended right away, most patients will spend a few weeks with their arm in a sling following reverse total shoulder replacement. Use of the hands and elbows and light work like writing or using a keyboard are typically allowed fairly quickly. Full movement of the shoulder is usually restricted for several weeks depending on how stable the surgeon feels the prosthetic joint is in the bone after surgery. The surgeon will advise you and your physical therapist on what activities, movements and positions are allowed and prohibited following your surgery. These are typically called “shoulder precautions,” and are used to limit or restrict motions or positions for a period of time to prevent dislocation or subluxation of the new shoulder joint while the tissues around it are healing.

Surgeons typically recommend that patients avoid certain movements or activities, lifelong, following a reverse total shoulder replacement, to limit the chance of dislocation and to prevent early wearing of the joint. Typical restrictions include

• Avoiding repetitive lifting of >25lbs, especially overhead
• Avoiding heavy bodyweight activities like push ups and pull ups
• Avoiding reaching behind the back as if to scratch it or fasten a bra
• Overhead reaching is often limited to about 150 degrees due to the nature of the reversed shoulder anatomy

In the weeks after your surgery your physical therapist may use modalities, manual therapy techniques or passive range of motion to address pain and inflammation and to start restoring motion. Your PT will also prescribe some of the interventions below to begin restoring tissue and muscle function and length. As you progress through your recovery and the surgical site is allowed to undergo more stress, your physical therapist will begin to progress these interventions in order to help you achieve your maximal level of function:

Strengthening: Restoring strength and endurance to the muscles around the shoulder (as well as the shoulder blades, elbow and wrist), is an important part of post-surgical rehabilitation. It will help decrease pain and assist you in returning to your prior level of function. Strength losses can be attributed to a decreased level of exercise or activity pre-surgery as well as a result of pain, inflammation and modified activity post-surgery.

Active and Active-assisted Range of Motion: regaining range of motion is important following surgery as well as a period of immobilization. Your PT will teach you how to safely begin performing range of motion exercises on the shoulder to help restore movement.

Stretching: Stretching is often needed after a surgery to restore normal joint motion and muscle length. Restoring full or functional range of motion is very important post-joint replacement and your PT will guide you on how to do this while maintaining shoulder precautions. .

Neuromuscular Re-education: This type of treatment is used to improve the motor control and coordination of muscles around the shoulder joint so the limb functions well during both daily tasks and higher impact activities like light athletics or job duties.

Sport and job-specific tasks: For athletes returning to light and surgeon-approved athletics or workers returning to a job, sport- and job-specific exercises will be incorporated later on in your rehabilitation to prepare the surgical site for the demands of returning to these activities.

While recovering from a surgery can seem like a long process, the therapists at Evolve are here to help you recover fully from a reverse total shoulder replacement. Call Evolve today to schedule your first appointment.