5 Things You Should Do After Shoulder Surgery

Under the heading of “damned if you do, damned if you don’t”, one thing rings true. If we don’t move enough, our bodies will not function properly. Adversely, if we do too much (especially repetitive motion), we can pay a price for that also. Our muscles, joints, and tendons can wear and tear just like anything else. If you are above the age of 50 like I am, then you may know exactly what I’m talking about. As a personal trainer and fitness instructor, I’m always telling people to “move it or lose it”. That’s because our muscles, joints, etc. need exercise to stay conditioned. That being said, I know that if I’m going to talk the talk, I have to walk the walk - even run sometimes! That walk, or that run, however, can be difficult when your knees are getting a little painful and stiff. This is where your age begins to kick in, and you realize that some things are becoming more challenging. 50 is definitely a pivotal age. I’ve said it before, and 7 years after hitting that milestone, I’m living it every day. It’s as if someone flipped a switch and suddenly, I have to watch what I do and how I do it!

Injury to the shoulder is one of the most common injuries seen in an orthopedic practice. According to a blog post by Ortho Bethesda, a network of orthopedic professionals, in the population at large about 25% of people age 40-60 years old have partial thickness rotator cuff tears. By age 60, 20%+ of the population has a full thickness tear (all the way through a portion of the tendon) and by age 80 over half the population has a full thickness tear. There are many people with a full thickness tear that have minimal or no symptoms and don’t know they have a rotator cuff tear.

In 2022 I had rotator cuff surgery on my right shoulder. Each year, around 4.5 million patients in the U.S. visit a doctor because of a rotator cuff injury. Nearly 250,000 of them are treated through arthroscopic surgery. Rotator cuff surgery is pretty routine, but it can have an extensive recovery period. Depending on the size of the tear, your rotator cuff injury may not need surgery. In fact, abstaining from activities that cause these tears can go a long way toward allowing minor tears to heal on their own. These activities include lifting heavy weights (over 10 lbs.), particularly overhead, as well as athletic activities like tennis or baseball.

Symptoms of a rotator cuff tear may include a dull ache deep in the shoulder, and numbness in the arm, accompanied by a decreased range of motion. However, the only way to know for sure that you have a tear is to get an MRI (magnetic resonance imaging). Once it is established that you do have a tear, like I did, the next step is to decide whether to let it heal on its own or have it repaired with surgery.

If you choose the latter, as I did, then here are some things you should know. The procedure is almost always ambulatory. You’ll be under anesthesia, and they may give you something called a nerve block to further numb the entire shoulder and arm. I got the nerve block, and it was the craziest thing. My arm was literally paralyzed and felt like dead weight for hours after the procedure! As crazy as that sounds, I’d hate to think about what I would’ve done without it. Once the nerve block wore off…whoa! I was prescribed oxycodone, but I didn’t take the doctor’s advice when he told me to take the pain killer almost immediately, to get ahead of the pain. I was convinced that with my relatively high tolerance for pain, I wouldn’t need the oxy. With today’s opioid problem, and how addictive they can be, I was reluctant to take it, even when I was in pain. By the time I actually took the pain meds, it took what seemed like an eternity before it kicked in.

I was told that the recovery process for such a surgery was a long road. A few months after my surgery, I had finished physical therapy and things were looking up. I was cleared to return to the gym, with restrictions of course, and I actually was feeling good. Then one day after working out, I started feeling pain and tingling in my arm and shoulder. I thought I had re-torn my rotator cuff. I went back to the doctor, and got another MRI, which revealed that it wasn’t a re-tear or failed surgery. It was a shoulder impingement, and unfortunately no one could explain how I got it. After numerous visits to the chiropractor, multiple trigger point injections, and an epidural, the pain persisted. The only alternative was to go back to physical therapy, and after about 8 visits, I began to feel some relief. After 20 visits, I couldn’t be approved for anymore, but the impingement was starting to let up. The numbness in my fingers was still there, but the pain was at a minimum. I continued doing the exercises my therapist gave me and began my own training program to strengthen my arm and shoulder, which had gotten so weak from the recovery. Now 18 months later, there is significant improvement in my strength, and mobility.

It was a long journey, but I learned a lot from the experience. So, here are the 5 things you should do after shoulder surgery:

1. Pain management. Take your pain meds as prescribed. More than likely you will be advised to take the painkillers as soon as you get home, to get ahead of the pain. Do not wait until the pain is so bad that you need to take more than instructed. If your pain becomes unbearable, consult with your doctor right away.

2. Rest and reflect. Use your recovery time to get plenty of rest and reflect on how you may have gotten the injury, and how to avoid it happening again.

3. Physical Therapy is a must. I can’t imagine anyone NOT being prescribed PT at some point after rotator cuff surgery, so if your doctor prescribes it DO IT! Also, it is important to be ALL in with your PT. Don’t just do the exercises during your visits. Most therapists will give you a printout of exercises to do at home, do them. It could make your recovery time considerably shorter. Click here to find a physical therapist in your area.

4. Begin a strength training program. Physical therapy will only go so far and after your therapy sessions have ended, most physical therapists will recommend that you continue to work on strengthening the weakened muscles in your shoulder and arms. The best way to achieve this is by working with a certified personal trainer. One tip I will give for training, use resistance bands and dumbbells, to train both your sides independently. Training with barbells is less effective, because the side you had surgery on will be weaker than the other, and with barbells the stronger side will take over. If you need help with this, feel free to contact me.

5. Listen to your body. Don’t repeat past mistakes, especially those that may have contributed to you injuring the shoulder in the first place. Recognizing that we may not be able to lift as heavy as we used to or run as fast as we used to are part of this getting older thing. If and when you do get back to your normal routine, don’t jump back in. Ease into it, and if your body is telling you you’re not ready…listen to it.