Total Shoulder Replacement Recovery
Total Shoulder Arthroplasty (Anatomic)
What the operation does
The worn ball at the top of the arm bone is removed and replaced with a metal ball on a stem set into the bone, and the socket is resurfaced with a smooth plastic cup. The shape of the normal shoulder is rebuilt — a ball on the arm side, a socket on the shoulder blade side — which is what the word anatomic means here.
Why this needs a working rotator cuff
The most important thing to understand, because it decides which replacement you had. An anatomic shoulder relies on the rotator cuff to hold the ball centred in the socket and to lift the arm. If those tendons are worn out, the ball rides upward, the replacement loosens and fails, and the shoulder does not work. So this operation is for arthritis in a shoulder whose cuff is intact — and where it is not, a reverse replacement is used instead.
The muscle at the front that was taken down
To reach the joint the surgeon has to move the subscapularis, the cuff muscle across the front of the shoulder, and repair it at the end. That repair is what governs your first six weeks, and it is the reason the restrictions may seem out of proportion to a joint replacement.
What you protect against
Turning the arm inward against resistance, because that is exactly what the repaired muscle does. Practically: pushing up out of a chair with the arm, reaching behind your back, tucking in a shirt, and lifting anything of weight. Turning the arm outward is also limited early, because it stretches the repair. Your surgeon may have set a specific limit in degrees.
Pain relief is the reliable part
Shoulder replacement is very good at relieving arthritic pain — most people describe it as gone rather than reduced, often within the first weeks once the surgical soreness settles. Movement and strength improve more gradually over months. Judging the operation on the first six weeks undersells it considerably.
How much movement to expect
Usually enough for everyday life — dressing, hair, shelves at head height. It is not a normal shoulder, and a shoulder that was very stiff beforehand tends to be moderately stiff afterwards. Reaching behind the back is often the last movement to return and sometimes stays limited.
The sling
Usually four to six weeks, largely to keep the arm out of the positions that stress the front repair. Coming out of it for the exercises is expected. It is protecting a muscle repair rather than the joint replacement itself.
What the replacement will not tolerate
Repetitive heavy lifting and impact through the arm. Most surgeons advise a long-term limit — often somewhere around ten to fifteen kilograms occasionally, and considerably less repeatedly — and advise against contact sport and heavy manual overhead work. Golf, swimming, tennis at a social level, gardening and cycling are usually encouraged.
How long it lasts
Anatomic shoulder replacements have a good record, with most still working well at ten years and many considerably longer. The usual reasons for later revision are the plastic socket loosening or wearing, or the rotator cuff failing over the years — which changes the shoulder into the situation a reverse replacement is designed for.
Night pain and sleeping
Sleeping is awkward for the first weeks, and many people sleep propped up in a recliner. The arthritic night pain that often prompted the operation usually goes early, and the discomfort that replaces it is surgical and temporary.
The hand, wrist and elbow
Should be moved from the start. Using the hand at waist height with the elbow at your side — eating, writing, a phone — is usually fine and encouraged. It is the shoulder's positions that are restricted, not the use of the arm entirely.
Numbness and nerve irritation
Nerves near the shoulder are stretched slightly during the operation, and temporary numbness or tingling down the arm is not unusual. It generally settles over weeks. Gentle nerve gliding is in the early programme for that reason.
Driving and work
Driving generally waits until you are out of the sling and can control the wheel with both hands comfortably — commonly around six weeks. Desk-based work is often possible within two weeks with the sling on. Work involving lifting or overhead reaching commonly waits three to four months, and heavy manual work may remain limited permanently.
How the first year usually unfolds
Six weeks in a sling with assisted movement and the front repair protected. Six to twelve weeks the sling goes and you begin moving the arm yourself. Three to six months brings strengthening, including the rotator cuff work that this replacement depends on. Six to nine months brings most activity back. Movement and strength continue improving out to a year and beyond.
Staying in touch with your care team
The state of your cuff and bone, and how the front repair heals, shape this recovery. Your surgeon knows those details. If something about your recovery is worrying you or does not match what is described here — particularly a sudden loss of the ability to turn the arm inward — contact your care team rather than waiting.
Exercises for Total Shoulder Replacement
An illustrated, phase-by-phase exercise program for this procedure. View the Total Shoulder Replacement exercise program.
Recovery education · Condition guides · Exercise programs
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This guide is general education and doesn't replace evaluation by a licensed provider. Recovery and treatment vary by person — follow the guidance of your own surgeon or care team.