Reverse Shoulder Replacement: Recovery process

Posted by mimi99 @mimi99, Aug 1, 2018

I am scheduled for this surgery in September. I have been putting it off as long as possible, because I am worried about recovery. I don't have a lot of help and am very concerned with how well I will be able to handle daily living activities with the shoulder immobilizer. If anyone has gone through this recovery process, I would appreciate any advice or input you may have.

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@hsminc

If you were told you need reverse shoulder replacement surgery, there is probably a lot of damage. I was told in 2015 that I needed a total shoulder replacement. It was scheduled for 2016 but I backed out. I had undergone two knee replacements in 2015 and I just felt adding a third surgery would be too much.
I exercised in our heated pool and really did not have any pain. When I asked a surgeon why I had no pain, he said that my bones had fused together so there was no osteoarthritis to cause pain. I am not sure I understand that.
So, finally, in 2023, I had reverse shoulder replacement surgery on my left non dominant shoulder. I had no pain with the surgery nor after the surgery. I think it is common now to give you a type of lidocaine that gets pumped into the nerves going to your shoulder. You wear it for 2 1/2 days and by that time, the pain is pretty much gone.
I did not need pain meds - just tylenol. I also took celebrex. Celebrex may interfere with healing but I have taken it for a long time.
I don't know what my final range of motion will be. I am concerned that I have been a little aggressive about lifting stuff and also using that shoulder. Would I know if something is out of whack?? Not sure.

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I am 2 weeks post op and am waking up every morning with a dull ache in my arm. There is no position that will relieve it. Any suggestions?

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@cynthiakempton

I am 2 weeks post op and am waking up every morning with a dull ache in my arm. There is no position that will relieve it. Any suggestions?

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I would be concerned that something is "wrong" -but that is just me. Oddly enough I expected pain with this shoulder replacement - everyone told me it would be very painful - but I did not have any pain or discomfort at all. The exception was that the lidocaine like nerve block I had that was inserted in the nerves in my neck for two days plus some hours post surgery was uncomfortable. Also it made my left hand and fingers numb. That panicked me a bit.
You might ask for a blood test to determine if you have inflammation (C reactive protein, Sedimentation rate).
How long does the ache last? Have you tried rapid release tylenol gels? Celebrex and also Tylenol work for me. I did take Celebrex about a week after my surgery because my "native" right shoulder was starting to give me pain from being "overworked."

Do you sleep in a recliner? I had to sleep in a recliner until the sling came off. It was not a good experience but, again, I did not experience any pain because of it.

I would think that a dull ache would go away but I would pursue it - definitely.
I keep telling patients that they need to have any orthopedic surgery done by a a surgeon that specializes in doing just that body part. A shoulder surgeon should only be doing shoulders and elbows - and maybe wrists, if he or she is trained. Similarly, for a hip or knee shoulder -- that should be their only focus.
I do credit my pain free experiences to do just that - a dedicated Mayo shoulder surgeon and a dedicated Mayo hip and knee surgeon.
Good luck and keep us posted.

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@hsminc

If you were told you need reverse shoulder replacement surgery, there is probably a lot of damage. I was told in 2015 that I needed a total shoulder replacement. It was scheduled for 2016 but I backed out. I had undergone two knee replacements in 2015 and I just felt adding a third surgery would be too much.
I exercised in our heated pool and really did not have any pain. When I asked a surgeon why I had no pain, he said that my bones had fused together so there was no osteoarthritis to cause pain. I am not sure I understand that.
So, finally, in 2023, I had reverse shoulder replacement surgery on my left non dominant shoulder. I had no pain with the surgery nor after the surgery. I think it is common now to give you a type of lidocaine that gets pumped into the nerves going to your shoulder. You wear it for 2 1/2 days and by that time, the pain is pretty much gone.
I did not need pain meds - just tylenol. I also took celebrex. Celebrex may interfere with healing but I have taken it for a long time.
I don't know what my final range of motion will be. I am concerned that I have been a little aggressive about lifting stuff and also using that shoulder. Would I know if something is out of whack?? Not sure.

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Good afternoon @hsminc, @cynthiakempton, and others coping with reverse shoulder surgery. One of you has a dull ache in your arm every morning. Another wonders if she has been a bit aggressive about using the shoulder to lift "stuff".

I can share my ups and downs with you. However, I have a question. Do you all have a PT and have participated in post-surgery treatment with a focus on healing and regaining movement? Are you doing the "circles" every day?

When you sleep, how is your shoulder protected? Do you wear your sling 24 hours a day? Are you able to create a stable environment during the night by wearing an oversized t-shirt that keeps your arms tight to your body? That helps a lot.

Once you are free of the sling how will you support your arm? I actually wore vests and held the opening with my surgery side hand. Just enough support to prevent injury.

That is the beginning of my "you can do it" checklist. I have now had four shoulder surgeries and am considering a fifth one as a reverse on my left shoulder. Right now, my MFR therapist is working on it twice a week. The guided injection just hasn't made enough difference.

Regarding range of motion......I have discovered that my first reverse shoulder does a fairly good job of helping me get dressed and pack my overnight bag. However, eating an ice cream cone is a bit of a strange site as my elbow wants to remain higher than my shoulder. Even after 10+ years.....I still have occasional pain after too much activity.

Here's some good news. It is now possible to have the replacement mechanism
fitted to your body the same way that knee replacements are done. I also think you can have robotic surgery which guarantees less invasive and more accurate surgery.

Good luck to you all. And remember, I am here for you.
Let us know how you are doing and ask any questions you encounter. We can all help each other.

May you be safe, protected and free from inner and outer harm.
Chris

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@artscaping

Good afternoon @hsminc, @cynthiakempton, and others coping with reverse shoulder surgery. One of you has a dull ache in your arm every morning. Another wonders if she has been a bit aggressive about using the shoulder to lift "stuff".

I can share my ups and downs with you. However, I have a question. Do you all have a PT and have participated in post-surgery treatment with a focus on healing and regaining movement? Are you doing the "circles" every day?

When you sleep, how is your shoulder protected? Do you wear your sling 24 hours a day? Are you able to create a stable environment during the night by wearing an oversized t-shirt that keeps your arms tight to your body? That helps a lot.

Once you are free of the sling how will you support your arm? I actually wore vests and held the opening with my surgery side hand. Just enough support to prevent injury.

That is the beginning of my "you can do it" checklist. I have now had four shoulder surgeries and am considering a fifth one as a reverse on my left shoulder. Right now, my MFR therapist is working on it twice a week. The guided injection just hasn't made enough difference.

Regarding range of motion......I have discovered that my first reverse shoulder does a fairly good job of helping me get dressed and pack my overnight bag. However, eating an ice cream cone is a bit of a strange site as my elbow wants to remain higher than my shoulder. Even after 10+ years.....I still have occasional pain after too much activity.

Here's some good news. It is now possible to have the replacement mechanism
fitted to your body the same way that knee replacements are done. I also think you can have robotic surgery which guarantees less invasive and more accurate surgery.

Good luck to you all. And remember, I am here for you.
Let us know how you are doing and ask any questions you encounter. We can all help each other.

May you be safe, protected and free from inner and outer harm.
Chris

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Thank you for reaching out to us.
I am doing great so have questioned the need for a PT or an OT. I have had friends that have been injured by over enthusiastic PTs. One had to have her shoulder replacement redone. Another had the same issue with a knee replacement- the PT somehow tore the parts "apart." He had to have another knee replacement.
My OT sent info about choosing a "certified" PT, i.e., ones with special qualifications to address my needs. I don't know if I will do that. As it is, I spend two hours every day walking my shepherds and an hour exercising in our heated swimming pool; I am told not to swim until I am four months out. I haven't even reached the three month mark yet. I also do the prescribed exercises. It all takes up a whole lot of time.
I am not a fan of robotic surgery -not yet. Too many surgeons using it that are not optimally trained nor experienced.
I think my shoulder parts were planned and "fit" together the same way that my knees and hip were planned and fit. I don't think this is an entirely new procedure at many centers.

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@hsminc

Thank you for reaching out to us.
I am doing great so have questioned the need for a PT or an OT. I have had friends that have been injured by over enthusiastic PTs. One had to have her shoulder replacement redone. Another had the same issue with a knee replacement- the PT somehow tore the parts "apart." He had to have another knee replacement.
My OT sent info about choosing a "certified" PT, i.e., ones with special qualifications to address my needs. I don't know if I will do that. As it is, I spend two hours every day walking my shepherds and an hour exercising in our heated swimming pool; I am told not to swim until I am four months out. I haven't even reached the three month mark yet. I also do the prescribed exercises. It all takes up a whole lot of time.
I am not a fan of robotic surgery -not yet. Too many surgeons using it that are not optimally trained nor experienced.
I think my shoulder parts were planned and "fit" together the same way that my knees and hip were planned and fit. I don't think this is an entirely new procedure at many centers.

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@hsminc Your comments bring up the question, is a bad physical therapist worse than no PT ? A person should always be assertive and communicate immediately any time they feel something is too much for them!
A certified physical therapist has to first get a 4 year degree in a health related field, then a doctorate in Physical Therapy, so about 7 years of college total, then pass the national NPTE exam, then complete their individual state licensing requirements, then complete a residency program to gain hands-on experience before they are fully certified. There are additional certificates they can work towards in specialty fields like cardiovascular and pediatrics and others. Our local ortho clinic employs probably 10-15 full time PT's and though I have primarily tried to schedule with my same guy through rehab for two TKR's a rTSR, back pain, sciatica, and frozen shoulder sessions, I have seen maybe 5 others for a single session when he was booked up. In all cases, they were knowledgeable, professional and were careful to work up to a level of discomfort/pain which I chose. I cannot imagine any of them using enough force to tear anything apart. One benefit of going to a certified PT, is that they should be recording notes on your range of movement improvement each session and can suggest new exercises as you are ready for them. Especially with a first surgery, you may not have a notion of timeline to push yourself to try to stretch to extended your range, so that you end up permanently below your potential.

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I had my reverse (left) shoulder replacement exactly one year ago when I was 85 years old. I was not in a lot of pain - I only took once or twice a vicodin, but most of the time just 2 tylenol. I had to sleep the first 6 weeks in a recliner, but in fact I slept more than 3 months in the chair. I made it very comfortable with a big down comforter spread over it. It kept me from rolling on my side during the night.
I had minimal help - just 2 times a nurse came to help me shower. After one week I could do it alone - not easy but it was ok. The first 2 weeks I did not wear underwear, just had a long wide skirt - on the top I had an oversized T-shirt. On the internet you can find on youtube a film how to put a t shirt on after shoulder surgery. It worked for me perfectly. If possible, practice before surgery. It helps.
Now: I can raise my arm completely (however the dr. did not expect me to be able to do that) - I can bend my arm behind my back and I have zero pain. Not in the night, or daytime. I can sleep on the shoulder for hours. No problems at all. It is great!!!! But I have to say that I had a great PT.

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@ddsack

@hsminc Your comments bring up the question, is a bad physical therapist worse than no PT ? A person should always be assertive and communicate immediately any time they feel something is too much for them!
A certified physical therapist has to first get a 4 year degree in a health related field, then a doctorate in Physical Therapy, so about 7 years of college total, then pass the national NPTE exam, then complete their individual state licensing requirements, then complete a residency program to gain hands-on experience before they are fully certified. There are additional certificates they can work towards in specialty fields like cardiovascular and pediatrics and others. Our local ortho clinic employs probably 10-15 full time PT's and though I have primarily tried to schedule with my same guy through rehab for two TKR's a rTSR, back pain, sciatica, and frozen shoulder sessions, I have seen maybe 5 others for a single session when he was booked up. In all cases, they were knowledgeable, professional and were careful to work up to a level of discomfort/pain which I chose. I cannot imagine any of them using enough force to tear anything apart. One benefit of going to a certified PT, is that they should be recording notes on your range of movement improvement each session and can suggest new exercises as you are ready for them. Especially with a first surgery, you may not have a notion of timeline to push yourself to try to stretch to extended your range, so that you end up permanently below your potential.

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I don't think it matters for my purposes.
I have gone through three previous replacement surgeries and did not use PTs.
I am doing fine now and suspect I will continue to do so.

This is not the same certification that I was talking about. We do not have PTs with the level of education and certification you are noting here.
Thanks for the info. Am signing off now with this discussion.

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I had reverse shoulder joint replacement in March 2023. By August I was doing good. I did 4 months of rehab. I went to an inpatient therapy for 8 days right after surgery. If you are alone I would suggest the 21 days at a Rehab facility that Medicare pays for. It hurt a lot the first few weeks and you will need help but there is a end to this and you will get better

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