Most people are back to simple everyday tasks like eating, dressing and grooming within about TWO weeks of a total shoulder replacement. The shoulder keeps improving for a YEAR or more.
Expect a sling for roughly 2 to 6 weeks, strengthening from about 3 months, and a clear difference somewhere around 4 to 6 months. Small gains often keep coming for 12 to 18 months.
Your surgeon’s protocol comes first. The ranges below are typical, and yours may be faster or slower depending on your shoulder and your surgeon’s preference.
Total or reverse: which one did you have?
A total (anatomic) replacement copies your normal shoulder, with a metal ball on the arm bone and a plastic socket, and it needs a working rotator cuff. A reverse replacement swaps the ball and socket around for shoulders where the cuff has failed. This article is about the total.
For the other one, see reverse shoulder replacement.
Week by week
- Day 1 to 2: many people go home the same day or after one night. If you had a nerve block, take your pain relief before it wears off, not after
- Weeks 0 to 2: sling on most of the time, off for exercises and washing. The arm is moved FOR you, by your physio or your other hand. Turning the arm outward is limited, often to about 30 degrees
- Weeks 2 to 6: gentle assisted movement, a few times a day. Lift nothing heavier than a glass of water. The sling usually comes off somewhere in this window
- Weeks 6 to 12: sling gone. You start lifting the arm yourself and using it for light daily tasks. It will feel weak. That’s six weeks of rest, not a problem with the joint
- Months 3 to 6: strengthening for the shoulder and shoulder blade muscles. Most people notice the biggest change in this stretch
- Months 6 to 18: slow, steady gains in strength, reach and comfort
The American Academy of Orthopaedic Surgeons has a clear overview of the operation and early recovery if you want the background.
Why the first six weeks are about one tendon
To reach the joint, the surgeon usually detaches the subscapularis, the tendon at the front of the shoulder, and sews it back at the end. That repair, not the metal, is what the early rules protect.
- Don’t force the arm to turn outward. Stay inside the limit your surgeon sets, commonly around 20 to 30 degrees for the first six weeks
- Don’t push up out of a bed or chair with the operated arm. This is the rule people break most, usually first thing in the morning
- Don’t put the arm in extreme positions, like straight out to the side or reaching behind your body
- Don’t carry or lift anything heavier than a cup of coffee
- Do your exercises two to three times a day. Little and often beats one long session
The metal is ready on day one. The tendon at the front needs six weeks.
Sleep, washing and dressing
- Sleep on your back, propped up, with a pillow under the operated arm. Many units advise this for at least the first two weeks, and some want the sling on at night. See sleeping after shoulder surgery, as the same setup works here
- Dress the operated arm first, undress it last. Loose, button-front tops are easiest
- Wash your armpit by leaning forward and letting the arm hang a little away from your body
- Ice wrapped in a cloth for 15 to 20 minutes can settle soreness after exercises
What’s normal
- Bruising that spreads down the arm in the first week or two
- Aching after exercises that settles once you rest
- Night aching for the first few weeks, even when days are comfortable
- Stiffness at 6 weeks. You have been protecting the shoulder. It loosens with steady work. See stiff shoulder after surgery
When can I…
- Drive: not while you’re in the sling or on strong painkillers. Usually somewhere between 2 and 6 weeks, once you can turn the wheel firmly and do an emergency stop. Check with your insurer
- Go back to a desk job: often once the sling is off or nearly off and you can get there safely
- Go back to manual or heavy work: rarely before 3 months, after strengthening, and only with your surgeon’s say-so
- Play golf, swim or play doubles tennis: case by case from about 3 months. About 9 in 10 people who played a sport before a total replacement get back to it
- Lift heavy or play contact sport: usually discouraged long term. Your surgeon will set your limits. Use theirs
How long does it last?
- About 9 in 10 total shoulder replacements are still in place at 15 years without another operation
- The most common long-term reason for a redo is the plastic socket working loose. Wear of the rotator cuff over the years is another
- You protect it by avoiding repeated heavy lifting and hard falls onto the arm. For the background on the arthritis itself, see shoulder arthritis
Call your surgeon today if
- The wound is red, swollen, weeping or leaking pus
- You have a fever or feel unwell, or the shoulder pain is climbing instead of settling
- The shoulder suddenly clunks, looks out of shape, or you can’t move it. It may have dislocated
- You feel a pop at the front of the shoulder, then new pain and weakness
- You have new numbness or weakness down the arm
Go to the emergency department if
- You have chest pain or sudden shortness of breath
- The arm turns cold, pale or blue
Mention it at your next review if
- Movement has stopped improving for several weeks despite your exercises
- Night pain is still waking you most nights at 3 months
- Aching after exercise lasts hours rather than minutes, again and again
The joint is new on day one. The shoulder takes a year to catch up.