Shoulder Surgery Recovery

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Shoulder Pain, Back Surgery

Published: 27 November 2015

If you have to go into Surgery on your shoulder, then the underlying problem is quite severe, such as a major tear in the rotator cuff. The surgery will normally involve an arthroscopic procedure or an open surgical procedure.

The recovery from surgery will depend on the type and extent of shoulder surgery that you have undergone. However, whatever the surgery - the aim of rehabilitation is to recover as much of the position, movement, strength, and ultimate function of your shoulder joint and girdle as can be achieved.

When considering recovery and rehabilitation from shoulder surgery, particular attention to detail is required in each and every case, as the shoulder is a complex structure, containing many ligaments, tendons and muscles around the shoulder joint and bones.

Lets have a look at the different aspects you need to take into consideration when you have had your operation and have commenced the recovery process…

Things to consider when in your recovery from shoulder surgery

Position

Your shoulder joint is a ball and socket joint. The role of the ligaments and muscles are to hold the ball part of the joint correctly into the bony socket. Without these soft tissues, the ball part of the joint would hang downwards resulting in a dropped shoulder and its associated problems. (see Shoulder Anatomy for more)

After surgery, some of your ligaments and muscles will have been disturbed if not cut through. In order for them to recover well they must be immediately positioned correctly to heal. In the early stages this may involve a brace to assist the soft tissues in their early stages of healing.

• Before you leave hospital: If the early stages are not dealt with correctly - and the ball either heals too close to the socket or too far away - the result may be ongoing problems with tendons and muscles being impinged resulting in pain and dysfunction.

  So early attention to detail is important and you must clearly understand what position your shoulder joint needs to be in so as to facilitate these early stages of recovery. Talk with your surgical team and be clear on this before you leave the hospital. Don’t leave it until your next appointment, as that even may be too late!

• Early Stages of recovery: Once the early stages of healing have occurred a chartered physiotherapist/physical therapist will advise you on the appropriate shoulder exercises to facilitate your muscles to work effectively and ensure the correct positioning of your shoulder joint.

  In my experience, people who have shoulder surgery - without an intensive early and regular follow up from a trained therapist - nearly always have ongoing shoulder and neck problems. So be prepared and if you can, seek have the right therapist for your problem before your surgery. Preferably attend your therapist before your surgery so they know the condition your shoulder was in before the operation. This will help both of you in the recovery stages.

Movement

Your shoulder is a very mobile joint which moves in many directions. Forward and backward movements are known as flexion and extension respectively. Sideways movement away from your body is known as abduction, and towards your body adduction. The rotations of your shoulder are referred to as internal and external rotation.

When you move your shoulder it often involves a combination of two or more of these movements at any one time and therefore it is so important that you regain all these movements in your recovery and rehabilitation form shoulder joint surgery. Your therapist will advise you on this. Early attention to movement post operatively is more favourable than later in the long term resolution of your shoulder problem.

Regardless of pain seek early physiotherapy post-operatively. To regain movement your therapist will teach you both active and passive exercises. At the early stages you will use your good arm as well as a “pulley” device to keep your joint moving and over time you will progress to active movements where you work your affected arm in many ways eventually using resistance devices such as therabands and weights where appropriate. Do what you’re told!

Strength

Strengthening the shoulder post surgery involves attention to detail, and is an aspect of recover which I feel we often don’t recover fully. Over time, you will regain a certain amount of strength just from everyday use of your arm. However, in order to prevent problems down the line a shoulder strengthening exercise program is preferable. Your therapist needs to continually assess your strength and you need to do all the exercises they tell you to do over a longer period of time than you think!

Although you may have returned to normal life and feel confident - there is a timeframe during which you need to continue specific strength exercised. I generally advise 6 months of same, but obviously each individual case is different.

Function

The nature of the shoulder surgery you have undergone will determine the functionality in which you should be aiming to return to. It is important that you understand this, as if you have ruptured a muscle it may not be advisable to return to heavy weight lifting too soon.

Always work under the guidance of a well trained physiotherapist/physical therapist in this field as abusing your operated shoulder at any stage may cause further harm. On a positive note I have never had a poor result from shoulder surgery in my clients once they have followed my advice, programme and time frame for same correctly.

Shoulder Surgery Rehabilitation

In Summary

Shoulder surgery is quite a big deal, and it is usually performed only when all other options have been exhausted. You should prepare for the recovery from your shoulder surgery before you go under the knife if possible. Consult with your physiotherapist and surgical team about your recovery both before and after the event.

It is important that you are clear about the position you should hold your shoulder in and exercises you are to do. In my experience, patients who are diligent in following their exercises prescribed by the surgeon and physiotherapist have the best recovery prospects.