How Long Does It Take to Recover From Shoulder Surgery?

Undergoing shoulder surgery is a big deal. The whole process can take time- setting up pre-operative appointments, preparing for surgery, undergoing surgery, and surgical recovery are all major steps along the way. I often find that patient's get so wrapped up in the preparation phase pre-op that they fail to really consider the post-op recovery.

In my experience, surgeons tend to downplay the recovery time. This is especially the case when in comes to a timeline to return to a sport or recreational athletics. When I see patients for their first post-op visit, the majority of time is spent educating the patient on the timeline of recovery. Some patients are confused when I explain a timeline to them that is twice as long as what the surgeon said. As a physical therapist, there are many factors to consider when determining an appropriate timeline for recovery.

Factors Influencing Recovery Timeline

1. Age of the patient

2. General health and co-mordbities

3. Type of surgical procedure performed

4. The surgeons specific post-op protocol

5. Previous level of acitivity

6. Patient goals

General Timeline:

• Phase 1: Initial Recovery (2-8 weeks)

• Phase 2: Intermediate Recovery (4-8 weeks)

• Phase 3: Dynamic Strengthening (4-8 weeks)

• Phase 4: Return to Activity/Sport (4-8 weeks)

Total recovery time: 14-32 weeks (3.5-8 months)

The following is a general overview of the timeline for post-operative recovery. You should always consult with your MD and PT prior to initiating any rehab program.

Phase 1: Initial Recovery (2-8 weeks)

In the initial recovery stage, the patient is often immobilized in a sling. Depending on the surgical procedure and the doctors protocol, this phase usually lasts for the first 2-8 weeks after surgery.

Primary Complaints During Initial Phase of Recovery

• Post-operative pain

• Difficulty sleeping, disrupted sleep

• Discomfort with wearing a sling

• Lack of independence/ reliance on others

Rehab Focus During Initial Phase of Recovery

• Pain management

• Protect the surgical repair/surgical site

• Decrease risk of infection

• Gentle passive range of motion (depending on surgical procedure)

• Education

Phase 2: Intermediate Recovery (4-8 weeks)

In the intermediate recovery phase, the patient will begin to perform progressions of basic exercises. These will most likely include passive range of motion, active range of motion, isometric contractions, and isotonic strengthening. These phase is critical because it sets the stage for the following phases.

Primary Complaints During Intermediate Phase of Recovery

• Post-operative pain

• Difficulty sleeping, disrupted sleep (link to shoulder sleeper pillow)

• Stiffness- lack of range of motion

• Weakness- difficulty moving the arm againt gravity

Rehab Focus During Intermediate Phase of Recovery

• Pain management

• Protect surgical repair

• Progress range of motion

• Initiate strengthening exercises

Phase 3: Dynamic Strengthening (4-8 weeks)

This is where the rehab progression starts to get more exciting and fun. Patients typically have minimal pain at this point and can start progressing to more challenging exercises. The major focus of this phase is to get your shoulder stronger. In most cases, this is the time where there is a transtion from "PT exercises" to more of a "gym program."

Primary Complaints During Dyanmic Strengthening Phase of Recovery

• Stiffness- lack of range of motion

• Weakness- difficulty lifting heavier weights

Rehab Focus During Dynamic Strengthening Phase of Recovery

• Strengthening the rotator cuff and scapular muscles

• Introduce plyometric (more explosive) exercises

• Range of motion

Phase 4: Return to Activity/Sport (4-8 weeks)

Finally! Now is the time to make the exercises more specific to the patients sport. For example, this would be the time when a baseball player begins a throwing progression. The patient generally feels prepared for this next step because of the work put in the previous steps.

Primary Complaints During Return to Activity Phase of Recovery

• Shoulder soreness following activity

• Shoulder "feels different" performing the activity

• Performance of the activity is not quite at pre-operative levels

Rehab Focus During Return to Activity Phase of Recovery

• Gradually re-introduce the activity in a logical manner

• Manage the workload of the specific activity- avoid doing too much too soon

• Continue to work on strength and range of motion

I hope this article is a helpful guide to explain the post-operative recoery timeline. Keep in mind, each individual is different and may progress at a different rate. Stay patient and keep a positive mindset and it will most likely go well for you!