Shoulder Surgery Exercises: Complete Rehabilitation Guide

What Should I Know About Shoulder Surgery Rehabilitation?

Shoulder surgery rehabilitation is an individualized process that depends on your specific injury and the surgical procedure performed. The key to successful recovery is following your physical therapist's instructions precisely, never increasing exercises on your own, and using pain management strategies to enable consistent exercise.

Recovery after shoulder surgery varies significantly from person to person. The type of exercise program you need depends on several factors, including the nature of your original injury, the surgical technique used, and the condition of the bones and soft tissues around your shoulder joint. Some patients may have had arthroscopic procedures with small incisions, while others may have undergone open surgery or total shoulder replacement.

It is crucial that you primarily follow the specific instructions from your physical therapist or surgeon. These professionals understand your unique situation and can adjust the program based on how your shoulder is healing. The exercises and timelines described in this guide are general recommendations, and your healthcare team may modify them based on your progress.

One common mistake patients make is trying to accelerate their recovery by doing more exercises than prescribed or advancing to harder exercises before they're ready. This can actually slow down healing or even damage the surgical repair. The tissues that were operated on need time to heal, and pushing too hard too soon can undo the work your surgeon performed.

Take pain-relieving medication as prescribed before your exercise sessions so that you can perform the movements without excessive discomfort. You can also use cooling methods such as ice packs or bags of frozen vegetables wrapped in a towel to reduce pain and swelling after exercising. Always wrap ice in a cloth rather than applying directly to skin, and limit application to 15-20 minutes at a time.

Using a Sling or Shoulder Immobilizer

You will likely need to use a sling or shoulder immobilizer after your surgery. This device supports your arm and protects the surgical repair during the initial healing phase. Most patients wear a sling for 4-6 weeks, though this varies based on the type of surgery performed.

If you are using a shoulder immobilizer (also called an abduction brace), it holds your arm slightly away from your body. This position is important for certain types of repairs, particularly rotator cuff surgery. Your surgeon will tell you which device is right for your situation.

When wearing a sling, loosen the strap around the wrist several times daily and straighten your elbow. This helps reduce swelling and prevents stiffness in the elbow joint, which can become a secondary problem if the arm is kept immobilized continuously. Even though your shoulder needs protection, your elbow and hand do not need to be completely immobilized.

What Are Phase A Exercises (Immediate Post-Surgery)?

Phase A exercises begin immediately after surgery and continue for 4-6 weeks. These exercises reduce swelling, prevent elbow stiffness, and maintain good posture. Perform them every hour while awake, or as often as possible. You can do these exercises while wearing your sling.

The first phase of shoulder rehabilitation focuses on protecting the surgical repair while preventing the common complications of immobilization. When your arm is kept still in a sling, several problems can develop: swelling accumulates in the hand and forearm, the elbow becomes stiff, posture deteriorates, and muscles begin to weaken.

Phase A exercises address these issues without putting stress on the healing shoulder. The movements target your hand, elbow, and posture rather than the shoulder joint itself. This may seem counterintuitive when you've just had shoulder surgery, but keeping these other areas mobile is essential for overall arm function.

You should begin these exercises on the first day after surgery or as soon as you feel able. Continue performing them for 4-6 weeks, or as long as you are wearing your sling. If your physical therapist has given you different instructions, always follow their guidance over general recommendations.

What Are Phase B Exercises (Early Mobility)?

Phase B exercises begin approximately 6 weeks after surgery or when you no longer wear a sling. These exercises help relax your shoulder and gently improve range of motion. Perform them 2-3 times daily. Your physical therapist will confirm when you're ready to start.

The transition from Phase A to Phase B marks an important milestone in your recovery. At this point, approximately 6 weeks after surgery, the initial healing has occurred and your surgeon or physical therapist has determined that gentle shoulder movement is safe. However, this doesn't mean you should push hard - these exercises are designed to be gentle and controlled.

The primary goal of Phase B is to help your shoulder relax and begin moving again. After weeks of immobilization, the muscles around your shoulder joint may be tight and guarded. These exercises use gravity and your body position to create gentle movement without forcing the shoulder.

Continue following your physical therapist's guidance throughout this phase. The timing of when to start Phase B varies depending on your surgery type and individual healing. Some patients may need to wait longer than 6 weeks, while others with simpler procedures might begin sooner.

What Are Phase C Exercises (Active Mobility)?

Phase C exercises begin when your physical therapist or surgeon determines you are ready, typically 8-12 weeks after surgery. These exercises actively improve shoulder range of motion. Use your non-operated arm to assist movement, keeping the operated arm as relaxed as possible. Perform 2-3 times daily.

Phase C represents a significant progression in your rehabilitation. At this stage, you begin actively working on improving your shoulder's range of motion. However, the key principle is to use your non-operated arm to assist the movement rather than forcing your operated shoulder to work hard on its own.

This assisted movement approach protects the healing tissues while still achieving the goal of improved mobility. The muscles and tendons that were repaired need to gradually take on more load over time. By using your other arm to help, you can achieve greater range of motion while still protecting the repair.

Your physical therapist will provide specific guidance on when to begin these exercises. The timing depends on your type of surgery and how your healing has progressed. Some repairs require longer protection before active exercises begin.

What Is the Typical Recovery Timeline?

Recovery time depends on surgery type: arthroscopy takes 3-6 months for full recovery, rotator cuff repair takes 6-12 months, and shoulder replacement takes 6-18 months. Most patients return to basic daily activities within 6-12 weeks, but complete recovery requires patience and consistent rehabilitation.

Understanding the typical recovery timeline helps set realistic expectations for your rehabilitation. However, it's important to remember that every patient heals differently, and your recovery may be faster or slower than average depending on many factors including your age, overall health, the severity of your original injury, and how consistently you follow your exercise program.

The timeline below provides general guidance, but your surgeon and physical therapist will give you more specific expectations based on your individual situation. Trust their guidance even if it differs from these general timelines.

Factors That Affect Recovery

Several factors influence how quickly you recover from shoulder surgery. Understanding these can help you optimize your rehabilitation:

• Consistency with exercises: Patients who perform their exercises regularly as prescribed typically recover faster
• Pre-surgery condition: Better shoulder strength and mobility before surgery often leads to faster recovery
• Age: Younger patients generally heal faster, though older patients can still achieve excellent results
• Overall health: Conditions like diabetes or smoking can slow healing
• Nutrition: Adequate protein and nutrients support tissue healing
• Sleep: Quality sleep is essential for tissue repair
• Avoiding setbacks: Following precautions prevents re-injury that would delay recovery

What Precautions Should I Take During Recovery?

Avoid lifting more than a coffee cup weight for 4-6 weeks. Don't reach overhead, push, or pull with your operated arm until cleared. Don't sleep on your operated shoulder for 6-8 weeks. Never force movement beyond comfortable range, and always follow your physical therapist's specific guidelines.

Protecting your surgical repair is just as important as doing your exercises. The tissues that were repaired need time to heal and strengthen before they can handle normal loads. Pushing too hard too soon is one of the most common causes of complications after shoulder surgery.

These precautions may feel restrictive, but they are temporary. Following them carefully now leads to better long-term outcomes than ignoring them and risking damage to the repair.

Signs to Watch For

While some discomfort is normal during recovery, certain signs may indicate a problem that needs medical attention. Contact your surgeon or physical therapist if you experience:

• Increasing pain: Pain that gets worse rather than gradually better over time
• Signs of infection: Increasing redness, warmth, or drainage from the incision
• Fever: Temperature above 38°C (100.4°F)
• Numbness or tingling: New or worsening numbness in your hand or arm
• Inability to move: Sudden loss of ability to move your arm
• Unusual sounds: Clicking, popping, or grinding that wasn't present before

When Should You Seek Medical Care?

Contact your healthcare provider if you experience increasing pain, signs of infection (redness, warmth, drainage, fever), numbness or tingling, or sudden loss of movement. In emergencies, contact your local emergency services or go to the nearest emergency department.

Most recovery from shoulder surgery proceeds smoothly when patients follow their exercise program and precautions. However, complications can occur, and recognizing when to seek help is important for protecting your surgical outcome.

Don't hesitate to contact your healthcare team if you're unsure whether something is normal. It's better to ask about a concern that turns out to be nothing than to ignore a warning sign of a real problem.