What is it?
A shoulder replacement is an orthopedic procedure in which the two surfaces that form the shoulder joint are replaced by a prosthetic joint. The two surfaces replaced are the glenoid, part of the scapula, and the humeral head, which is the proximal most part of the humerus, the upper arm bone. The joint is a ball (humeral head) and socket (glenoid) joint. The shoulder joint is the most mobile in the body and because of this when range of motion (ROM) is lost it can be very debilitating.
How Does it Happen?
There can be many conditions that lead to needing a shoulder replacement including, osteoarthritis, rheumatoid arthritis, avascular necrosis, and numerous failed surgeries.
Symptoms
With all these conditions, pain that limits the individual to use their hand leads to decreased function.
What Can You Do?
After surgery you will go through physical therapy to control pain and inflammation, improve strength and ROM, and restore function. Normally the hospital stay is a short one and is determined by your surgeon. You may or may not receive physical therapy in the hospital.
Initially, rehabilitation will begin with gentle passive ROM exercises, meaning the procedural arm is moved by your therapist. You will leave the hospital in a sling and be asked to wear the sling for up to a month. The purpose of the sling is to protect the replacement. Between two and four weeks you will be limited to lifting no more than a cup of coffee. Physical therapy for the first 2-4 weeks will be centered around basic ROM and strengthening exercises, teaching use of the sling, how to maneuver without using the surgical arm, and how to perform your daily activities like brushing your teeth, getting in/out of bed, and getting dressed without use of the surgical arm. You will not be able to drive for up to two weeks after surgery. Pain is common up to 3 months post surgery and will be controlled through multiple modalities including cryo/thermal therapy, laser therapy, electrical stimulation.
Progression after the initial phase of rehabilitation will be individually based and decided upon by you and your therapist. Gaining full ROM will be the first goal to allow full use of your arm for all your daily tasks. Strengthening will continue to be done in a pain free range of motion and progressed by your therapist. Rhythmic stabilization will then be incorporated into your program to give you the stability you need. Rehabilitation will take between 6 to 12 months at which time you will have full pain-free use of your arm for all daily, work, and recreational activities.
