Shoulder Replacement Surgery: Range of motion?

Hi Chris,
I did not have an ice machine, just the flat blue nylon and velcro ice pack pad that I came home with from the hospital. I did ice my shoulder lots off and on during the first few days, and went to sleep with the ice pack over my shoulder. But after a couple of weeks, I started forgetting to do it, because the shoulder never was that visibly swollen, and I didn't crave the icing like I did with my knees after TKR's.

I used my immobilizer/sling day and night for about four weeks, then started to leave it off at night. I am a quiet sleeper so don't toss around much and I had been leaving just the wrist connector off at night anyway. I used the immobilizer during the day about 6 weeks, but mostly just connected at the elbow, rarely needed the wrist connector. I could still get a lot of everyday hands-on things done with the elbow held rigid, but the wrist mobile. The immobilizer is so much better than a traditional sling.

I used a bed wedge topped with one pillow for sleeping, had much less trouble sleeping than with either of my knee surgeries. At first it was just a matter of not being able to lay on my right shoulder because of the surgical site irritation, but as that faded I could find more alternate positions, now at 8 weeks out, I can sleep fully on the right side, and have a better night's sleep than when I was dealing with the pre-surgery arthritic pain.

My last appointment with my surgeon was between the 6 and 7 week mark, and he said I have no restrictions other than common sense in not pushing myself past unreasonable points of pain. Obviously I won't be lifting super heavy objects yet, but I've been refilling my humidifiers which are just under a gallon, and I can handle a gallon of milk, supported a bit with the left hand if needed. I can drive, but luckily I have not had to -- my husband is around to take me to my PT appointments. We have had some weeks of snow and icy roads --not much use of sand and salt here, so I'm just as happy to not have to drive on slippery highways.

I have no pain, and most of the time I am not aware that I have a shoulder implant. It only verges on pain when I extend too far in one of the directions that still needs more work on strength and stretching. At home for now, I have band exercises with the band end knotted behind a closed door, both in high and low positions. Also some prone exercises on my stomach that work my shoulder blades. In a reverse TSR, you no longer have a rotator cuff, so your deltoid muscles have to get stronger to take over the work of the missing rotator muscles. I was told that makes recovery from a reverse TSR faster than a regular TSR, because you no longer also have wait for the smaller finicky rotator muscles to heal properly.

I had an RSA done this June, literally never had to take a pain pill after the nerve block wore off, mobility came back pretty quickly I’m at five months now almost 6 and probably have 75% range of motion and at least the same in strength.Where I’m lacking is in external rotation but that was pretty much gone from the seven surgeries I had prior to the replacement. I waited three years because of Covid and insurance snafus to get the surgery done and believe me it was worth the wait, I’ve had issues with my shoulder since the early 70s and this is the first time it’s felt normal in almost 35 years.

Broke my shoulder 7 weeks ago (humorous) fracture, not very dislocated. Pain is terrible. No surgery, out of sling, 2nd PT TODAY.
I am scared because healing seems to be a problem for me. I am thin, look good, yet feel very vulnerable at 80. I walk every day, lifted weights before I fell, wonder what I CAN DO TO PROMOTE faster healing. Even a scratch from my pup takes weeks and weeks to heal.
ANY IDEAS?

You are in the same fix I am...bone on bone shoulder, PT 2x a week, rail thin, older than dirt and in pain......My usual routine of zumba 5x a week not good as I can't help but go with the music so I am (reluctantly, hating it) doing the recombent bike and slow treadmill in our gym, just to keep body moving.....watching mindless TV while pumping away. It is the only thing I can think of to keep up cardio..I do PT 2x a week and will be paying out of pocket after next week as medicare stops covering rehab after 6 weeks...

Please check again on the rehab! Medicare will pay beyond 6 weeks on a case-by-case basis if you are progressing. After my wrist surgery a few years ago, healing was slower than anticipated and I was able to get 2 extensions - the first for 6 weeks, the second foe 3 more. The same applied in 2020 to my pain rehab PT - it lasted over 3 months 2X/week, then 3 more months weekly - since I was making progress.
Have you had the therapist and/or referring doc request an extension?
Sue

Not yet. I will ask her today.

@callie642 - slower healing just seems to be something we have to accept at our older age. Seems like any bump or bruise looks worse than it is and takes longer to heal.
About the only thing you can do is make sure you have a healthy diet with extra calcium and vitamin D and maybe other supplements. Before my recent TSR, the nurse giving the pre-op presentation stressed that it was important to eat lots of protein during the healing process to aid the damaged muscles in repairing themselves. The easy change I made was for breakfast, eating more eggs instead of always my usual oatmeal.

You got good advice. Mine said nothing about any such thing. When I asked if my doc would need an MRI her comment was that some do and some don't.
The person I talked to at the new Surgeon's office was surprised that no MRI was done before the TKR.

I don't know why some Dr's ask for MRI's and some work only from xrays. Maybe it depends on what they see in the preliminary xrays and individual possible problems surrounding the bone.

I had the same great surgeon for both of my TKR's and my reverse TSR. For the knees, I only had a new set of x-rays taken, no MRI's. Both knees recovered well without problems.

For the shoulder, I had x-rays, CT scan and MRI's done to determine whether I would have a regular or a reverse procedure, then another special MRI to provide my measurements for a custom made implant. I think the first CT and MRI's were to determine whether my rotator cuff was in any shape to save (it was not.)

So in my case, I'm assuming my surgeon thought my knees would be fairly routine, so didn't require the MRI's, while he did need it for more information on my shoulder.

Good evening @ddsack and @kartwk. Perhaps this might help with the issue at hand. I had a Mako Robotic surgery for my second TKR. There were lots of special images taken to be used to create the model that guided this minimally. invasive surgery.. I had an MRI before my first TKR 10 years ago. As technology continues to make better surgical techniques, the support images may change. And this is my own opinion. However, I will ask my surgeon when I go for my 6-month appointment.

Did you discuss this with your "great" surgeon?

May you have comfort and ease.
Chris