Standard Shoulder Replacement PJK65 in Recovery

[Jockette]

then 3 months of therapy 3 times a week.

I realize therapy is much more important after shoulder surgery than we have found for knee replacement. Is shoulder therapy fairly standard and agreed upon by therapists, or does one still have the beware of wrong PT like with knees?

 

[Jamie]

I have heard of therapists that get a bit too aggressive with the therapy on shoulders. It's the same rule on any joint....you should not have pain....only mild discomfort with any therapy. You never should try to "work through pain" when recovering from a joint replacement or other surgery.

 

[PJK65]

I remember when I was recovering from labrum surgery that my active physical therapy was three times a week for 8 weeks, not sure what the doc is going to order for the TSR rehab, will find out today, but I agree with what Jamie said, PT shouldn't result in pain.

 

[PJK65]

Met with surgeon yesterday for post op visit, he was pleased with range of motion. For now he wants me to continue with passive range of motion exercises and doesn't intend for me to begin strengthening for four more weeks, is this typical? For now I'm allowed out of my sling around the house but need to wear it whenever I go out, it feels good to be out of the sling. I hope all are well.

 

[Jamie]

This is all very typical. Normally you'll have 6 weeks of passive exercises before starting a regular therapy program.

My surgeon allowed me out of my sling at home from the beginning and that has made a huge difference. I have limited movement, but I feel like even the little bit I can do has helped my arm regain strength. I still have to wear it when I sleep, though.....bummer as it is now very uncomfortable for me.

 

[PJK65]

Hi everyone, hi hope all are well. I'm 18 days post op and am doing well. I continue to do only passive range of motion exercises. I'm fortunate in that I'm relatively pain free, what pain I do have is generally managed by Tylenol. I do have to vent though, I'm getting really frustrated that I can't do more, it's hard feeling like I can't contribute to my family and to work that needs to be done. I can do a few minor tasks around the house like feeding the dog, doing the dishes and sweeping the floor, but it doesn't seem like much. It just gets to be a little bit depressing. That being said, I'm trying to maintain a positive attitude, and I'm grateful that thus far I've had a pretty smooth recovery.

 

[Jamie]

I hear what you're saying! I feel the same at just a little over 4 weeks out. It is B-O-R-I-N-G doing those passive exercises which really don't give you any feeling of gain or accomplishment. And since I too don't have a lot of pain, I tend to feel like I "should" be able to do more. It's a battle to fight the urge to try to do things like some cleaning around the house, changing sheets on the bed....just "simple" things. But we have to fight the urge and be good. It's important to heal and attempting to push it could risk doing some damage or setting back our recovery. Hang in there and remember this is only temporary and it will pass.

 

[PJK65]

Thanks Jamie, I appreciate your words. It does just seem that without pain it should be possible to do more, but I'm also aware that I don't want to "undo" all the good work that the surgeon did. Guess I'm going to work on being content with doing the "little things" for now. I hope your recovery is going well.

 

[PJK65]

Still plugging along, some concern of late this week, seems I'm losing some range of motion with my passive ROM exercises, not alot but a noticeable amount. Also noticing some discomfort when I'm doing the exercises. Going to watch it over the weekend, and if it doesn't improve will give the doc a call on Monday I suppose.

 

[Jamie]

Discomfort is probably okay as long as it's not actual pain. There is a subtle difference sometimes. But I think your plan to contact your surgeon's office if things continue to worsen over the weekend is a good one.

Since you've been feeling so good, have you slacked way off your pain medications? If so, this could be part of the problem. Also, be sure you are doing those exercises with very slow movements. Don't try to hurry the motions. The idea is to keep your joint mobile at this point in your recovery. You are not really working to gain strength or significant increases in range of motion.

 

[PJK65]

The only pain medication I'm on at this point is Tylenol, 1000mg every 6 hours as needed. I'm also icing pretty regularly, about 20 minutes every two hours. I'm just going to keep up with the PROM exercises and, as you said, focus on doing them slowly and just make sure I keep the joint moving at this point. Hopefully it will start feeling better in the next day or so. Thanks for your feedback Jamie, I hope you are well.

 

[PJK65]

Well, today is four weeks post op. The pain/discomfort I had been feeling seems to have stopped, some occasional discomfort and some muscle pain, but overall it's been good the past couple of days, range of motion seems to be getting a bit better as well without discomfort. At this point I'm really grateful that I had this surgery, and I'm anxious to start the strengthening phase of the recovery in a couple of weeks.

 

[Jamie]

Sounds like your recovery is progressing much as mine did. I'm 2 weeks ahead of you and continue to feel better every day.

 

[PJK65]

Five weeks post op, range of motion still not quite where I'd like it to be, but it will come. Some odd discomfort from time to time on the top of my shoulder and also in my bicep, but aside from that pain free! Anxious to see my surgeon on the 17th so that I can get release to start driving, and can begin more aggressive physical therapy/strengthening.

 

[PJK65]

Met with surgeon today for 6 week follow up, everything looking good, finally out of the sling and released to drive! Still restricted to only lifting a "cup of coffee" with affected arm for the next 6 weeks; starting physical therapy for strengthening next week. Having some occasional discomfort, but nothing like prior to the surgery, so thus far I have to so I'm very pleased.

 

[Jamie]

Hooray! Great report. I think once you get into therapy you'll start seeing even more good results. Be sure your therapist not only does exercises but also soft tissue manipulation. The latter has been the key to my progress. It's all about getting those muscles back to working in the proper fashion. They've been on vacation too long.

 

[PJK65]

First meeting with physical therapist today, all we did was measuring range of motion. She mapped out what she plans to do, and it isn't aggressive at all, simply continuing what I've already been doing at home with PROM exercises and introducing some light strengthening with therapy bands. Have to admit, I'm a bit disappointed, I was hoping we could go at a more brisk pace than this. Patience.

 

[SportHog]

I was also at my physio today. Nothing exciting other than a few more exercises. It appears to be a slow process.

 

[Jamie]

It is a very slow process. My therapist explained that it's important to get the proper range of motion passively first and then work on strength. If you go directly to strengthening the muscles, the muscles that have not been used properly will never engage and you'll keep all the compensating bad habits you had pre-surgery. In essence you have to "teach" those lazy muscles that haven't been fully engaged as you moved your bad shoulder how to work again.

I think she's right because almost all my therapy has been passive exercises for the past 2 weeks. It is my rotator cuff muscles that are lazy and need to be retrained. Slowly they are coming around and now I'm allowed to do just a little bit of the strength-building.

 

[PJK65]

Well, made a big mistake this weekend and got ahead of myself. Was at my in laws and decided to help spread mulch, couldn't resist the compulsion to try to unload the mulch from the trailer and shovel it into the wheelbarrow, I just wanted to be helpful. Well, after two hours of shoveling, needless to say, my shoulder and arm are paying for it now. I'm icing and using tylenol, am doing my PROM exercises but they are very uncomfortable to do. I tried doing my strengthening exercises with my theraband this morning, but they were painful. Needless to say, I think I overdid it and should have followed the doctor and PT"s warning not to lift anything "heavier than a cup of coffee". Now I think I understand why I have to be patient. I'm hoping that by tomorrow things will have calmed down a bit.