Reverse shoulder replacement is a major surgical operation, performed on patients with severe shoulder damage when other treatments have proven unsuccessful. Because of the major repair, reverse shoulder replacements require an extensive physical therapy program. This program is divided into four phases, and can last up to several months.
Reverse Shoulder Surgery
Reverse shoulder surgery is an operation in which the bones of your shoulder joint are replaced with a prosthesis. In a normal shoulder joint, the top end of the upper arm bone is shaped in a ball. This ball fits into a socket formed by your shoulder blade. With the prosthesis, the structure of the shoulder is reversed. The implant is designed so that the ball portion is attached to the shoulder blade and the socket is placed at the upper end of the arm bone. Reverse shoulder surgery is done mainly for the treatment of arthritis or degenerated rotator cuff muscles, and is usually only performed when all other treatment options have been exhausted. When your shoulder gets to a stage of extreme pain and weakness, mechanical changes must be made.
Phase One
Phase one lasts from one to six weeks post-op. The goals of phase one are to promote healing of soft tissue, maintain the integrity of the replaced joint and enhance range of motion. You will be wearing a sling for most or all of phase one. Exercises performed during this time include flexion and elevation of your shoulder and arm, and range of motion of your cervical spine, elbow, wrist and hand. Once you can tolerate these exercises you can continue to phase two.
Phase Two
Phase two is from six to 12 weeks after surgery. Goals of this phase include continued progression of range of motion and re-establishing shoulder stability. You will perform many of the same exercises as in phase one, while incorporating external and internal shoulder rotations. After about nine weeks, you can begin to use light weights of 1 to 3 lbs. while doing your exercises.
Phase Three
Phase three, from 12 weeks on, focuses on moderately increasing shoulder strength. Your goals are to enhance functional use of your arm, as well as shoulder mechanics, muscular strength and endurance. Your program will continue with gentle resistance exercises.
Phase Four
Phase four, typically four months post-op and beyond, is your continued home program. At this point, exercises can be performed at home, three or four times per week. You should focus on continued strength gain and a return to normal household activities. Eventually, you should be able to maintain pain-free motion in your shoulder and resume daily activities.
