What is a shoulder replacement, and who has one?
A shoulder replacement swaps the worn surfaces of the shoulder joint for a metal and plastic implant. The most common reason is wear and tear in the joint (osteoarthritis). The World Health Organization (WHO) estimates that about 73% of people with osteoarthritis are over 55 [1].
Other reasons include a badly broken upper arm and a rotator cuff that has failed for years. Our page on rotator cuff repair explains when the tendon can be saved instead.
Total or reverse: why does the type matter?
In a total replacement, the surfaces are replaced in their natural positions. In a reverse replacement, the ball and socket swap places, which lets a large shoulder muscle (the deltoid) lift the arm when the rotator cuff cannot.
The rehab rules differ between the two, and between surgeons. That is why we read your operation note at the first visit. We adjust the exercises and the pace to what your surgeon asked for, and we explain the reasons.
What are the stages of rehab?
Stages follow the surgeon’s protocol.
- Sling stage. The new joint is protected. You move the hand, wrist and elbow, and learn how to dress and wash with the sling.
- Assisted movement. The arm is moved for you, with your own muscles relaxed.
- Active movement. You begin to lift and rotate the arm, with permission.
- Strengthening. Resistance is added in small steps.
- Return to daily tasks and light activity.
You cannot rush these stages. Stiffness also needs attention, so we keep the shoulder moving within the safe range.
Which daily tasks do we practise at home?
Recovery is judged by tasks, not by degrees on a chart. We choose the ones that matter most to you.
- Eating and drinking with the operated hand once allowed.
- Washing and toileting hygiene, with the sling off when permitted.
- Dressing: operated arm in first, out last.
- Combing hair, and later reaching a high shelf.
- Pouring from a kettle, and lifting a light pot.
- Pushing up from a chair, only after the surgeon agrees.
Our guide on shoulder pain at night has ideas for sleeping comfortably, and surgeon rehabilitation instructions lists what to ask at review.
What does a home visit add for an older adult?
People who need a shoulder replacement are frequently older, and the operation can make them dependent for a while. A home visit lets us see the real kitchen, bathroom and bed, and train a helper or relative to assist without pulling on the arm.
If you also worry about balance, ask us. A fall onto the new shoulder is the last thing you want, so we check your walking and the home for hazards. Our older adult rehabilitation page explains that side of care.
When should you call the surgeon or go to hospital?
Call your surgeon if the wound opens or leaks, the shoulder is hot, red and very swollen, you have a fever, or the hand turns cold, pale or numb. Seek urgent care after a fall onto the arm, or if the shoulder suddenly looks out of place.
Go to the emergency department for chest pain or breathlessness. Tell us afterwards so we can adjust the plan.
Home visit or Canning Garden centre?
Home visits across Ipoh are available now, and they suit the sling stage. Our Canning Garden centre near Fatimah Hospital is opening soon, and may suit the later strengthening stage.
Prices differ for home and centre, and we give a quote on WhatsApp after a short description. Read about post-surgical rehabilitation.