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Description

You had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made of metal and a metal ball that fits on the top of the stem. For a total shoulder replacement, a plastic liner is used as the new surface of the shoulder bone's joint.

Now that you are home you will need to know how to protect your shoulder as it heals.

What to Expect at Home

You will need to wear a sling for the first 6 weeks after surgery.

Self-care

Rest your shoulder and elbow on a rolled up towel or small pillow when lying down to keep your arm and hand at the same level as your body. This helps prevent damage to your shoulder from the stretching of the muscles or tendons. You will need to keep doing this for 6 to 8 weeks after your surgery, even when wearing a sling.

Your surgeon or physical therapist may teach you pendulum exercises to do at home for 4 to 6 weeks. To do these exercises:

• Lean over and support your weight with your good arm on a counter or table.
• Hang your arm that had surgery down.
• Very carefully and slowly swing your loose arm around in circles. 
• You can squeeze your shoulder blades together periodically to exercise your back muscles.
• You should also straighten your elbow periodically to avoid stiffness.

Your surgeon or physical therapist will also teach you safe ways to move your arm and shoulder:

• Do not try to lift or move your shoulder without supporting it with your good arm or having someone else support it. Your surgeon or therapist will tell you when it is OK to lift or move your shoulder without this support.
• Use your other (good) arm to move the arm that had surgery. Move it only as far as your doctor or physical therapist tells you is OK.

These exercises and movements may be hard but they will get easier over time. It is very important to do these as your surgeon or therapist showed you. You have to do them by yourself every day and not just wait for your physical therapy sessions which are just 1 to 2 times a week. Doing these exercises will help your shoulder get better faster. They will help you be more active after you recover.

Activities and movements you should try to avoid are:

• Reaching or using your shoulder a lot
• Lifting objects heavier than a cup of coffee
• Supporting your body weight with your hand on the side you had surgery
• Making sudden jerking movements

Wear the sling all the time unless your surgeon says you do not have to.

After 4 to 6 weeks, your surgeon or physical therapist will show you other exercises to stretch your shoulder and gain more movement in your joint.

Returning to sports and other activities

Ask your surgeon which sports and other activities are OK for you after you recover.

Always think about how to safely use your shoulder before you move or start an activity. To protect your new shoulder avoid:

• Activities that require doing the same movement over and over again with your shoulder, such as weight lifting.
• Jamming or pounding activities, such as hammering.
• Impact sports, such as boxing or football.
• Any physical activities that need quick stop-start motions or twisting.

You will probably not be able to drive for at least 4 to 6 weeks after surgery. You should not drive when you are taking narcotics. Your surgeon or physical therapist will tell you when driving is OK.

When to Call the Doctor

Contact your surgeon or nurse if you have any of the following:

• Bleeding that soaks through your dressing and does not stop when you place pressure over the area
• Pain that does not go away when you take your pain medicine
• Swelling in your arm
• Your hand or fingers are darker in color or feel cool to the touch
• Redness, pain, swelling, or a yellowish discharge from the wound
• Fever of 101°F (38.3°C) or higher
• Shortness of breath or chest pain
• Your new shoulder joint does not feel secure and feels like it is moving around, shifting, or out of position

References

Edwards TB, Morris BJ. Rehabilitation after shoulder arthroplasty. In: Edwards TB, Morris BJ, eds. Shoulder Arthroplasty. 2nd ed. Philadelphia, PA: Elsevier; 2019:chap 43.

Throckmorton TW. Shoulder and elbow arthroplasty. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

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