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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@artscaping

Good evening @tfarizona. I read your post before my walk this evening and then spent some time thinking about it while swinging in a swing along the Mississippi. My shoulder surgery was a reverse meaning that what I call the "ball and socket" are switched. It was also my third surgery on that shoulder which means that I had been in considerable pain and discomfort for quite some time.

Here is what Mayo Clinic states about PT prior to shoulder replacement......"Mayo Clinic provides dedicated, individualized physical therapy sessions for all patients prior to surgery." I can attest to the purported individualization as I am currently in a patient unique PT program to prevent falling by increasing my strength and balance.

Is your surgery scheduled at Mayo Clinic?

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

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Yes my surgery is scheduled at Mayo Clinic Arizona.

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I would go with what your surgeon recommends. I asked mine about any special exercises before my reverse TSR last year, and he said no.

If your arm is painful enough to be thinking of shoulder replacement, it's probably bone on bone along with arthritis and very restricted movement of that arm. Chances are you have already gone through PT for a simpler solution and it has not given much relief. In order to build or improve muscle fiber you have to work it to past a point of discomfort so the muscle has a reason to thicken. The problem is that your point of severe pain from your bone on bone will prevent you from even getting your muscle up to it's point of discomfort, so all you'll have is pain without any gain.
Shoulder replacement has a very different schedule from knee replacement. With knees, they want you up and walking and moving as much as you can immediately. With shoulders, you wear an immobilizer sling day and night for up to 6 weeks. You do not start PT at once, when and what depends on whether you had a regular or a reverse procedure. You may do two or more daily sessions of various arm pendulum swinging exercises which only keep the rotational channel of your new joint working well, but don't involve any muscle activity. So any new muscle which you thought to build in the weeks before surgery will probably fade away due to enforced inactivity of that arm for the next month.
Again, I suggest checking with your doctor or surgeon.

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@tfarizona

Thanks for your response. I will look into PT prior to surgery.

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You're welcome and best of luck to you!

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@ddsack

I would go with what your surgeon recommends. I asked mine about any special exercises before my reverse TSR last year, and he said no.

If your arm is painful enough to be thinking of shoulder replacement, it's probably bone on bone along with arthritis and very restricted movement of that arm. Chances are you have already gone through PT for a simpler solution and it has not given much relief. In order to build or improve muscle fiber you have to work it to past a point of discomfort so the muscle has a reason to thicken. The problem is that your point of severe pain from your bone on bone will prevent you from even getting your muscle up to it's point of discomfort, so all you'll have is pain without any gain.
Shoulder replacement has a very different schedule from knee replacement. With knees, they want you up and walking and moving as much as you can immediately. With shoulders, you wear an immobilizer sling day and night for up to 6 weeks. You do not start PT at once, when and what depends on whether you had a regular or a reverse procedure. You may do two or more daily sessions of various arm pendulum swinging exercises which only keep the rotational channel of your new joint working well, but don't involve any muscle activity. So any new muscle which you thought to build in the weeks before surgery will probably fade away due to enforced inactivity of that arm for the next month.
Again, I suggest checking with your doctor or surgeon.

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Thanks for the info. Very interesting. I didn't know PT was so limited after a shoulder replacement. I'm guessing the arm pendulum exercises are to prevent scar tissue.

I'm likely a candidate for shoulder replacement. I appreciate the info.

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@tfarizona

Yes my surgery is scheduled at Mayo Clinic Arizona.

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Wonderful. Then your surgeon will be following the Mayo guidelines. Be sure and be careful.
Chris

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@ddsack

I would go with what your surgeon recommends. I asked mine about any special exercises before my reverse TSR last year, and he said no.

If your arm is painful enough to be thinking of shoulder replacement, it's probably bone on bone along with arthritis and very restricted movement of that arm. Chances are you have already gone through PT for a simpler solution and it has not given much relief. In order to build or improve muscle fiber you have to work it to past a point of discomfort so the muscle has a reason to thicken. The problem is that your point of severe pain from your bone on bone will prevent you from even getting your muscle up to it's point of discomfort, so all you'll have is pain without any gain.
Shoulder replacement has a very different schedule from knee replacement. With knees, they want you up and walking and moving as much as you can immediately. With shoulders, you wear an immobilizer sling day and night for up to 6 weeks. You do not start PT at once, when and what depends on whether you had a regular or a reverse procedure. You may do two or more daily sessions of various arm pendulum swinging exercises which only keep the rotational channel of your new joint working well, but don't involve any muscle activity. So any new muscle which you thought to build in the weeks before surgery will probably fade away due to enforced inactivity of that arm for the next month.
Again, I suggest checking with your doctor or surgeon.

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Will do, thanks.

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@artscaping

Good evening @tfarizona. I read your post before my walk this evening and then spent some time thinking about it while swinging in a swing along the Mississippi. My shoulder surgery was a reverse meaning that what I call the "ball and socket" are switched. It was also my third surgery on that shoulder which means that I had been in considerable pain and discomfort for quite some time.

Here is what Mayo Clinic states about PT prior to shoulder replacement......"Mayo Clinic provides dedicated, individualized physical therapy sessions for all patients prior to surgery." I can attest to the purported individualization as I am currently in a patient unique PT program to prevent falling by increasing my strength and balance.

Is your surgery scheduled at Mayo Clinic?

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

Jump to this post

Good for you Chris. Great information. Question - under what conditions is a reverse shoulder replacement done?

All the best,

Joe

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For my RTS no pt for 2 weeks then pt begins and overtime gets intense
At least for me I was in pt for a year I have great range motion still doing all my RTS exercises every day still get dry needling done as there are issues I have that the surgeon was unable to fix All in all much better quality of life

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@heyjoe415

Good for you Chris. Great information. Question - under what conditions is a reverse shoulder replacement done?

All the best,

Joe

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Heyjoe415.....hi there. So let me see if I can explain the need for reverse shoulder replacement.
1. I feel down a mountain, breaking my elbow in three places and dislocating my right shoulder. The first surgery was an attempt to repair the rotator cuff. It failed. My surgeon called it "the Grand Canyon of holes".

2, The second attempt was a cadaver surgery and it didn't even get off the ground. There was just too much damage to the connective tissues in and around the shoulder connection. And so....the battle with my insurance company began to approve a reverse. There wasn't enough reparable tissue to support shoulder movement.

3. I was also in pain 24/7. So....we finally got the O.K.from the insurance company and there was actually a celebration going on in my surgical room as my surgeon and his team had been hoping this would be the outcome. This surgery was some time ago and the "reverse" had just taken off across the country after its development in France.

4. Both my surgeon and my anesthesiologist came to my room that evening and stayed to make sure I was comfortable and able to sleep. I even got a private room so everyone could come and party without making too much noise. It was truly a celebration after a long two-year wait.

5. My recovery went well and I live with gratitude every day.

May you be free of suffering and the causes of suffering.
Chris

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@heyjoe415

Good for you Chris. Great information. Question - under what conditions is a reverse shoulder replacement done?

All the best,

Joe

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My understanding is that a reverse is done when the rotator cuff muscles are too weak or damaged to heal in a way that would bring back good shoulder function.
Your surgeon will find this out through CT and MRI scans to evaluate what needs to be done before well before surgery.

My surgeon said my rotator cuff was borderline, frayed, and gave me the choice of surgeries, but suggested the reverse because he thought I would eventually need the reverse anyway if my rotator cuff continued to deteriorate. Since I have no interest in going through surgery twice, I opted for the reverse procedure.

The main difference in a reverse, will be that it will be physically impossible to reach very high behind your back. I can get my hand just barely up to my waist in back with some effort and discomfort. All other directions are no problem.

I don't even think about the shoulder on a normal day, there is no discomfort or pain. Tend to be faster to heal from a reverse procedure, because the front rotator cuff muscles are gone, don't have to wait for them to heal. You can start PT a couple of weeks earlier.

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