What to Expect Before and After Shoulder Surgery

Shoulder surgery is often recommended for people who have endured long-term pain, loss of function, or injury that hasn’t responded to less invasive treatment. Whether the procedure is performed for arthritis, rotator cuff tears, fractures, or instability, understanding the stages before and after surgery can help make the process smoother and recovery more manageable. Preparing both physically and mentally plays a key role in how the body responds to the operation. Knowing what to expect can help patients feel more confident heading into surgery and more prepared for the path that follows.

Once the decision for shoulder surgery is made, preparation begins several weeks before the actual date. Pre-surgical planning involves a mix of physical readiness and logistical coordination. Doctors may recommend physical therapy to strengthen the surrounding muscles, which can support recovery. They may also ask for blood tests, X-rays, or MRIs to update imaging and assess the current state of the joint.

At home, setting up a recovery area with daily-use items within arm’s reach is recommended. Since one arm will have limited mobility, tasks such as dressing, cooking, and bathing may need assistance at first. Arranging for someone to help during the first week or two can make the transition smoother. Medications such as anti-inflammatory drugs or blood thinners might need to be paused before surgery, depending on the doctor’s instructions. Patients often meet with the anesthesiologist beforehand to discuss options and determine any special considerations based on their medical history.

The day of surgery begins with hospital check-in, usually a few hours before the operation. After registration, patients change into surgical attire and are taken to the pre-op area. There, nurses place an IV line and review the patient’s medical information. The surgical team confirms the procedure and marks the correct shoulder for surgery.

Anesthesia is typically administered right before entering the operating room. Most shoulder procedures are performed under general anesthesia, though regional nerve blocks are sometimes added to reduce post-operative pain. Once in the operating room, the team works to position the patient, clean the area with antiseptic solution, and begin the procedure.

Recovery begins immediately after surgery, though the first week can be the most challenging. Swelling, bruising, and discomfort are expected. The arm is typically placed in a sling to keep it immobilized. Most patients experience limited movement and rely heavily on the uninjured arm for daily activities. The timeline and approach to recovery vary based on the type of surgery performed. For those recovering after shoulder replacement, the early days focus on pain control, rest, and gentle motion. Physical therapy often begins within the first week, emphasizing small passive movements to prevent stiffness without straining the healing tissues. While progress might seem slow at first, small milestones, like being able to sit upright, sleep more comfortably, or dress with minimal help, are strong indicators of improvement. Adherence to post-operative instructions, especially regarding sling usage and exercise routines, helps ensure the shoulder heals properly and regains function over time.

Physical therapy becomes a central part of the recovery process. It usually starts with passive movements, where the therapist moves the shoulder gently while the patient stays relaxed. These sessions aim to maintain joint flexibility and prevent scar tissue from forming.

As the shoulder begins to heal, therapy progresses to active-assisted and active exercises. Patients gradually begin moving the shoulder with some help, then on their own. Over time, strengthening exercises are introduced. These focus on rebuilding muscle tone and improving shoulder stability.

Returning to normal activities depends on the type of surgery, the job or lifestyle of the patient, and how the recovery is going. Those with desk jobs may return to work within a few weeks, provided they avoid lifting or repetitive shoulder movements. More physically demanding jobs might require several months of healing before a safe return.

Driving is generally discouraged until the patient can move the shoulder safely without pain, has full control of the arm, and is no longer taking prescription pain medications. This point usually arrives around four to six weeks post-surgery, but can vary.

Household tasks, including cooking, cleaning, and personal care, gradually become easier as shoulder strength improves. Modifications like using slip-on clothing, switching to electric toothbrushes or razors, and relying on easy-to-reach kitchen items can help during the early phase of independence.

Shoulder surgery can offer meaningful relief from pain and restore function, but it involves a process that takes time, patience, and dedication. Whether undergoing a minor repair or a complete joint replacement, knowing what to expect before and after shoulder surgery helps turn uncertainty into confident, steady progress.