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What precautions should be taken after total shoulder replacement?

Shoulder joint replacement is a successful procedure in relieving joint pain. This procedure was first performed in the United States in the 1950s to treat severe shoulder fractures. With time shoulder joint replacement is done to cure other painful conditions of the shoulder, such as different forms of arthritis. In the US alone on average 50,000 shoulder replacement surgeries are performed each year, according to the Agency for Healthcare Research and Quality.  

If the patient is not getting relief from pain with nonsurgical treatments like medications and lifestyle changes, the shoulder surgeons may consider shoulder joint replacement surgery. Joint replacement surgery is a highly evolved and sophisticated procedure to help you resume everyday activities and cure the pain.

One of the important aspects that contribute to the success of shoulder replacement surgery is the precautions that one should take after the surgery.

Total Shoulder Replacement procedure

In the standard total shoulder replacement procedure the arthritic joint surfaces are replaced with a highly polished metal ball attached to a stem, and a plastic socket.

These artificial components come in various sizes and are either cemented or pressed to fit into the bone. If the patient’s bone quality is good, your surgeon may choose to use a non-cemented (press-fit) humeral component. For a patient with soft bones, the humeral component may be implanted with bone cement. 

The artificial parts include a stem made of metal and a metal ball that fits on the top of the stem. In the total shoulder replacement procedure, a plastic liner is used as the new surface of the shoulder bone’s joint.

What precautions should be taken after total shoulder replacement? 

After having the bones of your shoulder joint replaced with artificial parts and returning home you will need to know how to protect your shoulder as it heals.

Precautions to be taken at home

  • Sling is mandatory for the first 6 weeks after surgery.
  • Self-care: While lying down, rest your shoulder and elbow on a rolled-up towel or small pillow. When placed this way it keeps your arm and hand at the same level as your body which helps in preventing shoulder damage due to stretching of the muscles or tendons. Rest in this position for 6 to 8 weeks after your surgery, even when wearing a sling.
  • Exercises: Your surgeon and your physical therapist will teach you pendulum exercises to do at home. One has to do these exercises for 4 to 6 weeks. 
    • With your good arm, lean over and support your weight on a counter or table.
    • The arm that had the surgery should be hanging down. Slowly and very carefully swing your loose arm around in circles. 
    • The patient can squeeze their shoulder blades together periodically to exercise the back muscles.
    • Straighten your elbow periodically to avoid stiffness.
    • Be cautious and do not try to lift or move your shoulder without supporting it with your good arm or having someone else support it. 
  • Wait for your surgeon or therapist to tell you when it is OK to lift or move your shoulder without this support.
  • These exercises and movements will get easier over time and do them as your surgeon or therapist showed you. Practice on your own every day and not just wait for your physical therapy sessions which are just 1 to 2 times a week. Daily practice of these exercises will heal your shoulder faster and help you to be more active after you recover.
  • After 4 to 6 weeks of the surgery, your surgeon or physical therapist will show you other exercises such as stretching and shoulder movement exercises to increase the range of motion.

What to avoid for total shoulder replacement surgery?

  • Over Reaching or overusing your shoulder
  • Do not lift objects heavier than a cup of coffee
  • Do not lean with your hand on the side you had surgery
  • Avoid sudden jerking movements
  • Removing the sling without your surgeon saying so.

Returning to sports and other activities

  • Do not take up stressful exercises or sports without the OK from your surgeon. Before doing any activity, self-check if this is a safe activity for the shoulder. One should avoid the following activities on your “new” shoulder:
  • Activities involving repetitive use of your shoulder
  • No weight lifting.
  • No jamming or pounding activities like hammering.
  • Avoid impact sports, like boxing or football.
  • Jerky movements of the shoulder that need quick stop-start motions or twisting.
  • Avoid driving for at least 4 to 6 weeks after surgery. Start driving only when your physical therapist and your surgeon say it’s ok.

When should you go to the hospital immediately?

One must seek immediate medical attention if:

  • If your dressing is bleeding and does not stop when you place pressure on the area
  • If the pain medication is not reducing the pain.
  • If the surgical site is swelling
  • Change of colour of the hand or fingers and feel cool to the touch
  • Any yellowish discharge from the wound or redness.
  • If you have a fever, shortness of breath or chest pain
  • If you feel that the new shoulder joint is moving around, shifting, or out of position.

We at Hyderabad Shoulder Surgeons are very aware that precautions after total shoulder replacement are crucial in healing. We educate our patients about the home care they should take. After the surgery there are periodical follow ups and our doors are always open for any emergency. For more information please visit our website or contact us at +91 9959588389 or

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