By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- Total shoulder replacement is a procedure performed for people with significant pain and limited function due to shoulder arthritis
- Published studies show that about 95% of people return to sports participation
- General guidelines for return to sport: daily activity and light shoulder demand sports start in weeks 7-12 after surgery; full sport participation typically months 4-6 after surgery
Total Shoulder Replacement surgery is becoming increasingly common in the U.S., and for the right reasons in the right person it can be a very helpful operation. Active people in their 50s, 60s, and 70s should expect to see a meaningful improvement in quality of life, and in a very high percentage of cases a return to sport participation.
In this post I’ll outline the basics of total shoulder replacement, go over the types of sport you should expect to return to, and review the general timeline for return to sport.
The Problem: Arthritis Causes Pain, Limited Function
The surface of the bones in each of our joints is covered by an ultra-smooth gliding surface called “articular cartilage”. Broadly speaking, wear and tear of the articular cartilage can result in arthritis. The wear and tear can progress to the point where the cartilage is severely damaged. And this results in a stiff painful joint, with limited function for sports and daily activities.
In my sports medicine practice, the most common reason for shoulder arthritis in a person’s 50s or 60s is a history of multiple prior shoulder dislocations.
If non-surgical options fail, some people will be candidates for a shoulder replacement. In shoulder replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components.
The typical treatment options are either replacement of just the head of the humerus bone with a metal alloy component, or replacement of both the ball and the socket (most common). For young people with arthritis, there may be hybrid options with a combination of metal component and biologic reconstruction. Specific options require a careful discussion with a shoulder specialist.
Typical sports you can expect to do after shoulder replacement
In published clinical studies, a large percentage of patients undergoing total shoulder replacement list “inability to do sport or fitness activity” as one of the main reasons for having surgery. In all patient age groups, here are the common sports people return to:
- General fitness activity, e.g. resistance training, group fitness, yoga, cycling, running
Some patients have a goal of returning to high contact or collision sports, such as martial arts. This is possible in some circumstances, but will need careful discussion with your surgeon.
Return to sport rates are very high. In people under age 55, recent studies show a 96% rate of return to a wide variety of sports, usually with unrestricted participation at around 6 months after surgery.
Common postoperative timelines for return to daily activity and sports
My Stanford colleague Geoff Abrams publishes his postoperative protocols on his website. Have a look here for his total shoulder replacement protocol. Here’s what we generally aim for:
- First 6 weeks: Arm in sling, very limited use of the shoulder in order for the rotator cuff and soft tissues around the shoulder to heal.
- Weeks 7-12: progress to light activities of daily living. Stationary bike and running are often possible during this period
- Months 4-6: advance to sport activities. In the studies listed above, nearly everyone is back to unrestricted sport activity by the end of the 6thmonth