A shoulder replacement is a big operation and therefore it is normal to experience pain afterwards. The pain from your operation is linked to the scale of the surgery and is likely to be with you for some time. It could last weeks or months, but again, this doesn’t necessarily mean that anything is going wrong, as it is normal and to be expected.
Shoulder Replacement
The following information has been written in line with the Physiotherapy and Surgical teams at the James Paget University Hospital. If you have had your operation at another hospital, you should refer to the information and advice you were given as it may differ from the information below.
What is a shoulder replacement?
A shoulder replacement is an operation that involves replacing all or part of your shoulder joint with an artificial joint. There are different types of shoulder replacement:
• Reverse shoulder replacement
• Total shoulder replacement
• Partial shoulder replacement (hemiarthroplasty)
Why have I had a shoulder replacement?
Some people will undergo a shoulder replacement due to an underlying complaint such as osteoarthritis, that has not improved with physiotherapy and/or has become increasingly difficult to manage and live with. In some cases, a shoulder replacement is required following a fracture (broken bone), injury to the shoulder joint/upper arm or a condition that means surgery is really the best option. The aim of a shoulder replacement is to try and help reduce pain and improve your ability to use your arm for normal day-to-day activities.
What should I expect after having a shoulder replacement?
It is important for you to know what is normal after having your shoulder replaced. We’ve broken the answer down into things that are found most common:
What can I do to help my shoulder recover?
There are lots of things you can do to help your shoulder recover. To make it easier to understand, we’ve broken this information down into stages that match your recovery and rehabilitation.
These pages have been written in line with the protocols used by the James Paget University Hospital. If you have had your surgery elsewhere, please refer to the information provided to you by your hospital.
Don’t forget to come back to this page for more useful information about your new shoulder.
Click on the blue boxes to find out more:
Is there anything I should look out for?
After any operation, it is important for you to be aware of what is normal (see above) and perhaps, what is not. Below is a list of things that should be raised to your doctor, surgeon or practice nurse if you experience them after your surgery. If you have previously had a Deep Vein Thrombosis (DVT), you should familiarise yourself with the list and monitor yourself for any issues.
If your wound edge becomes red, oozy and/or painful, please contact the ward that you were admitted to for your surgery. Please do not contact your GP. You will be asked to come into the hospital for a review by your consultant or their team.
Sudden change in breathing i.e. finding yourself breathless; coughing up blood or a new pain in your chest – this could indicate a medical emergency and you should call 999 or go to A&E)
What does a good result look like after a shoulder replacement?
As you would expect, everyone is very different, but after a shoulder replacement it is hoped that the pain you felt before your operation would have significantly improved and your ability to use the arm for day-to-day activities is much easier. It is possible that the movement of your new shoulder will improve following the operation, but it is worth knowing that some new shoulders do not move as much as they might have done before the operation.
A good result for a new shoulder would be being able to lift your arm to about shoulder height. It is normal that people find putting their hand behind their head or back difficult, even after some time. It is hoped that by 12 weeks following your operation, you can regain as much movement as you had before the operation. There is often a large variation in how much movement comes back after a new shoulder, but if it is less painful and you can do more with it, it still means you’ve got yourself a good result.
How can I get the best out of my new shoulder?
Use it and enjoy it! Recovery after a shoulder replacement can sometimes be a bumpy journey and will take time. Often, you may not really get a good idea of just how good the result is until you are 12 months post-operation.
If you want to make sure you get the very best out of your new shoulder, getting or keeping yourself fit and strong will make sure that you, your body and your new shoulder are in the best shape to enjoy it. You will find a selection of movement and strengthening exercises below that you may be interested in to try to get your shoulder and arm strong enough to do more with it.
FAQ
Below are some of the common questions that are asked when talking about shoulder replacements that haven’t been covered in the information above.
Q: Will I be in pain after my shoulder replacement?
A: It is natural to feel some pain after your operation but this will gradually improve in time. You might need to take pain relief after the operation until your pain settles and to allow you to perform your exercises. Interestingly, you may find that any pain you feel may be more in the arm or down to the elbow rather than in the shoulder. Again, this is normal and is called ‘referred pain’.
Q: When can I have a shower or bath?
A: Aim to keep the wound dry until it has healed (normally 8 to 10 days). You can wash with waterproof dressings but you should avoid submerging underwater e.g. in a bath. After 10 days you should be able to shower without the dressing.
Q: Are there any positions I should avoid in the early stages of my recovery?
A: This may vary dependent on the type of surgery you have had and the surgeon who did it. If you have specific do’s and don’ts from your surgeon, then please stick to them until told otherwise by either your surgeon or your physio. Below are some of the things that are commonly advised against in the early stages of your rehabilitation:
- Scratching your back or doing your bra up
- Touching the back of your head
- Reaching backwards behind you
- Turning your arm away from your stomach if the elbow is bent (for example putting a car seat belt on)
Q: How long do I have to wear my sling?
A: You may be required to wear a sling for some time after the operation. Typically, it ranges from 4-6 weeks. If this applies to you, you should have been given specific instructions by your surgeon or the hospital. In most cases (please check with your surgeon or physio if unsure), you may remove the sling to perform washing and dressing activities and to complete your exercises.
Q: Can I sleep on the side of my operation?
A: You should avoid sleeping on your operated shoulder in the early stages of your recovery. You should try sleep on your good side or on your back (if you can) whilst wearing your sling in the initial stages following your operation.
A: We are all different. It is often not useful to compare yourself to others, even if you’ve had the same operation. How difficult your shoulder was before the operation, your strength and how well your pain is controlled are just a few things that will vary from person to person. Recovery from a major operation takes time and it best to think of this in terms of months rather than weeks.
Q: I’ve had my other shoulder replaced and it was much easier than this one, why’s that?
A: We are all different and so are your shoulders. Even though having a shoulder replaced is technically the same operation, given that it is done on a different shoulder means that it’s not exactly the same, therefore it is unlikely the result will be exactly the same. Things like your age, strength, fitness and general health all change over time and will play a role in influencing how you get on after your operation, including if it’s your second one.
Q: What exercises can I do to help my recovery?
A: You should be taught some gentle exercises before you leave hospital. You should continue with these until you are advised on different ones by your physiotherapist or surgeon. The exercises will help to improve range of movement and strength, so it is important that you start them straight away. Please be sure of any specific advice given to you about your exercises as some people are only allowed to do a certain amount of movement in the early stages following their surgery.
Q: How often should I do my initial exercise programme?
A: Aim to perform the exercises 3 to 4 times per day, but ensure you have adequate rest and pain relief to allow you to perform the exercises effectively. You should talk to your doctor, nurse or physiotherapist if the pain is preventing you from doing your exercises.
A: This is incredibly variable. Please do not try to rush back to driving as you need to be safe and fully in control of the vehicle at all times before you are able to use public roads. You may be able to drive when you no longer need to wear the sling, as long as you have good enough range of movement in your shoulder and have absolutely no hesitation with performing an emergency stop. Given the variability between people and how they recover from their operations, we cannot give you a specific timescale for you to be able to drive again. It is recommended that you inform your insurance company that you have had the operation and are planning to return to driving.
A: This depends an awful lot on the type of work that you do and how your recovery may be going. Normally, people of working age who have this operation are able to get back to some form of work after approximately 2-3 months, but again this is variable. You should discuss this with your consultant or physiotherapist if you are unsure.
Q: Will I need to have another shoulder replacement?
A: No, probably not. A shoulder replacement normally lasts at least 10 years and in some people up to 20 years. It is very rare for people to have issues with their first operation that means they need a second.