Pain guide · Shoulder pain

Exercises after a shoulder replacement: the stages, and the precautions for reverse and anatomic replacements

A shoulder replacement swaps a worn joint for metal and plastic parts. In an anatomic (total) replacement they sit where the originals were; in a reverse replacement the ball and socket swap places, so the deltoid muscle can lift the arm when the rotator cuff can't. The two need different precautions in the first weeks, so check which one you had. Recovery is slow: useful movement usually takes about 3 months, and the shoulder keeps improving for a year or two.

Your surgical team's protocol comes first, because hospitals differ on the sling, the limits and when each exercise starts. This guide sets out the usual stages from NHS hospital protocols and a US therapists' consensus, with a 3D demo of each move, the typical precautions, what trials found about early movement and home exercise, and the warning signs.

4-stage exercise plan When to get help 40 sourcesUpdated 21 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Go to A&E (call 999 if you can't get there, and don't drive yourself): after a fall, a clunk or an awkward movement, your shoulder looks out of place or has changed shape, or you suddenly can't move your arm. A replacement, especially a reverse one, can dislocate. Don't try to put it back in yourself.
A high temperature, or feeling hot, cold or shivery; or a wound that is red, hot, swollen or oozing: contact your surgical team, ask for an urgent GP appointment or get help from NHS 111. These can be signs of an infection. If you feel unwell and the wound looks infected, go to A&E.
Arm pain or swelling with breathlessness or chest pain: call 999 or go to A&E, and do not drive yourself. It can be a blood clot that has reached the lungs.
Throbbing pain and swelling in the arm, with red, blue or darker skin and swollen veins: ask for an urgent GP appointment or get help from NHS 111. It could be a blood clot.
Same day (your surgical team or NHS 111): once the nerve block has worn off, your arm or hand stays numb, you have pins and needles that don't go away or weakness you can't explain, or your hand turns cold, pale or blue.
Same day (your surgical team): you fall onto the operated arm, or you suddenly lose movement you had got back.
Call 999: shoulder or arm pain with chest pain that feels tight or squeezing, or chest pain that spreads to your arms, neck or jaw, especially with shortness of breath, sweating or feeling sick. It could be a heart attack.

See a doctor or physiotherapist if

After a reverse replacement, new pain over the top or back of the shoulder blade with new trouble lifting the arm, usually 3 to 10 months after the operation and after a spell of doing well: contact your surgical team. It can be a stress fracture of the acromion, the bony roof of the shoulder, and most are treated with a sling and rest from lifting.
You're not reaching the milestones your team set, or the shoulder is getting stiffer rather than freer: tell your physiotherapist or surgical team. The National Institute for Health and Care Excellence (NICE) says you should be offered supervised rehabilitation if your home programme isn't meeting your goals.
You've fallen, or you feel unsteady on your feet: ask your GP about a falls assessment.
New or worsening pain, or loss of movement or function, months or years after the operation: see your GP, who should refer you back to the orthopaedic team.

Understand it

Two kinds of shoulder replacement

In an anatomic (conventional) total shoulder replacement, the worn ball at the top of the arm bone is replaced with a metal ball on a stem, and the socket on the shoulder blade is lined with plastic, in their natural positions. It relies on a working rotator cuff, the group of tendons that steadies the joint. NICE says to offer it for osteoarthritis when there is no rotator cuff tear and the socket bone is good enough.

In a reverse replacement, the ball goes on the shoulder blade and the cup on the arm bone. That lets the deltoid, the large muscle over the shoulder, lift the arm when the cuff can't. It is used for large cuff tears with arthritis, some complex fractures and failed earlier operations, and NICE notes it is increasingly used even without a cuff tear. The American Academy of Orthopaedic Surgeons (AAOS) says most shoulder replacements in the US are now reverse. Replacing only the ball (a partial replacement) is another option, but NICE found a total replacement gives more benefit for osteoarthritis.

Sources 1, 2, 3, 4

Why the precautions differ

After a reverse replacement, the main early risk is the joint coming out of place (dislocating). A 2026 review puts it at about 2.5%, mostly in the first 3 months. The risky position is the hand behind the back, with the arm reaching back and across the body, so typical NHS hospital protocols ask you to avoid that position, and pushing up through the arm, for about 6 weeks. A US trial protocol tells people to keep the elbow where they can see it.

After an anatomic replacement, the main early risk is the tendon at the front of the shoulder (the subscapularis), which the surgeon detaches and repairs, pulling off before it heals. So protocols limit turning the arm outwards (in one NHS hospital's, not past pointing straight ahead for 3 weeks and not past 30° until 6 weeks) and avoid pushing or pulling against turning it in for 6 weeks. These are typical precautions; yours may differ, and your team's list comes first.

Sources 5, 6, 7, 8, 9, 10

What recovery looks like

Useful movement of your own takes about 3 months, and the shoulder keeps improving for 1 to 2 years. One NHS hospital's milestones after an anatomic replacement are half your movement from before the operation by 3 weeks, the movement you have with help back to that level by 6 weeks, and the movement you have on your own back to it by 12 weeks. A sudden loss of movement, or missing a milestone, is a reason to ask your team for advice.

After an anatomic replacement for osteoarthritis, the American Society of Shoulder and Elbow Therapists (ASSET) says people can expect to lift the arm to about 140 to 150°, turn it out to about 50 to 60°, and reach a hand up the back to about the level of the lowest ribs. After a reverse replacement, reaching behind the back usually stops at about the base of the spine because of the way the parts are made, so don't force it. The American Shoulder and Elbow Surgeons (ASES) expect a return to most activities at 4 to 6 months, with the best results at about a year.

Sources 9, 6, 10, 11

Complications to know about

Infection follows about 3 to 4% of reverse replacements in the reports a 2026 review gathered. A stress fracture of the acromion, the bony roof of the shoulder, follows 3 to 5% of reverse replacements, usually 3 to 10 months after the operation. It shows as new pain over the top of the shoulder and loss of lifting in someone who had been doing well. It is more likely in women, with osteoporosis and with age, and most are treated with a sling and a pause from lifting and physiotherapy.

Falls matter too: in one study of 198 people, 10.6% had a fall after going home that needed an emergency department visit or a hospital admission, some with an injury at the new shoulder.

Sources 5, 12, 13

What helps, and how strong the evidence is

Rehabilitation starts on the day of surgeryStrong evidence

NICE says a physiotherapist or occupational therapist should offer rehabilitation on the day of surgery if possible, and no more than 24 hours after: advice on daily activities, a home exercise programme and getting up and walking. Before you go home you should get advice on doing the rehabilitation yourself, in a group or one to one, with clear goals and someone to contact.

Source 2

The sling: plans differ, and a trial found no sling did as wellEmerging evidence

NICE found services advising a sling for anywhere from 10 days to 6 weeks, and no evidence on when the shoulder should start moving. A review of 16 published protocols found slings for 3 to 8 weeks after an anatomic replacement, and from comfort only to 6 weeks after a reverse one.

In a trial of 64 people after a reverse replacement (average age 73), 3 weeks in a sling gave no better pain or function at 1 and 2 years than no sling, and neither group had complications. After an anatomic replacement, the American Physical Therapy Association (APTA) guideline strongly supports a sling with progressive exercise, and in a trial of 36 people a sling holding the arm in a neutral position, rather than turned in, gave a bigger gain in outward turning, and less night pain at 2 weeks. Your team decides how long you wear yours.

Sources 4, 14, 15, 13, 16

Early movement after a reverse replacement: safe, with small gainsEmerging evidence

Three trials compared starting movement early with waiting. In 107 shoulders, physiotherapy straight away or after 6 weeks gave the same results at a year, apart from a bigger gain in function at 6 months in the group that waited. In 61 people, the early group lifted the arm better at 3 months, with no differences in scores at 3, 6 or 12 months. In the 64-person trial, no sling did as well as 3 weeks in one.

A 2025 review of 6 studies (1,763 people) found early movement gave about 4 to 5° more movement and slightly less pain, less than people would notice, with no more dislocations (1.4% against 1.5%). A 2026 review rated the evidence that early and delayed rehabilitation give similar results as low certainty.

Sources 17, 18, 15, 19, 20

Early movement and fractures: two findings that point different waysMixed evidence

The 2025 review also found fewer fractures around the replacement with early movement (3.3% against 8.8%), though the studies varied a lot. A review of stress fractures of the acromion cites a large database study in which starting physiotherapy within 6 weeks of a reverse replacement was linked with more of these fractures in people with osteoporosis, though not in people without it. A link like that doesn't show cause and effect.

Neither finding settles it. Follow your surgical team on timing, especially if you have osteoporosis.

Sources 19, 12

After an anatomic replacement, movement can wait a little without harmEmerging evidence

The APTA guideline says starting range of movement exercises can be delayed up to 4 weeks without harm (moderate evidence). In a trial of 60 people, starting movement straight away gave earlier function, but by 3 months there was no difference, and at a year the movement was the same (forward lifting 141° against 144°). The bone flake holding the repaired tendon healed in 81% with immediate movement against 96% with delayed movement, a difference that could be chance. In 66 people, adding exercises aimed at the repaired tendon made no difference.

Sources 13, 21, 22

After a reverse replacement, a home programme did as well as physiotherapy sessionsStrong evidence

Three trials, all after reverse replacements, found a home programme taught by the surgical team gave the same movement, strength and scores as outpatient physiotherapy. In 89 people at 2 centres, a handout and a rope pulley did as well, with complications in 13% against 17%. In 100 people, 70 of them followed for about 20 months, the only difference was slightly stronger outward turning after physiotherapy (0.8 kg). In the SHORT trial of 222 shoulders at 7 US hospitals, results matched at 1 and 2 years, and care cost about $11,300 at home against $17,800 with physiotherapy.

These trials were only after reverse replacements. No trial has compared the two after an anatomic replacement: NICE found no evidence, and a 2020 review found one moderate-quality study. NICE says you should be offered supervised rehabilitation if you struggle with daily activities, have ongoing problems, or your home programme isn't meeting your goals.

Sources 23, 24, 25, 4, 26, 2

Most people get back to golf and swimming, fewer after a reverse replacementEmerging evidence

A 2023 review found about 80% of golfers returned after a shoulder replacement, and the average time back to golf after a hip, knee or shoulder replacement was 4.4 months. A 2024 review of 10 studies found 78% returned after an anatomic replacement and 59% after a reverse one. The two reviews drew on different sets of studies, so their figures don't compare directly.

In 102 swimmers, 82% returned after an anatomic replacement and 64% after a reverse one. Another review found 91% returned to sport after an anatomic replacement and 80% after a reverse one, and the reasons people didn't return were mostly not the shoulder; a review of reverse replacements alone found 85% returned to sport. All of this comes from observational studies.

Sources 27, 28, 29, 30, 31

After a broken shoulder, results are a little lowerEmerging evidence

When a reverse replacement is done for a broken shoulder rather than for cuff tear arthritis, results are on average a little lower: in 11 observational studies (6,698 people), shoulder scores were about 5 points lower out of 100, forward lifting 14° less and lifting to the side 17° less, with more repeat operations for dislocation. The broken shoulder guide covers the fracture itself.

Source 32

Exercise before the operation: unprovenMixed evidence

NICE found no evidence on exercise before a shoulder replacement, partly because pain often limits it, and made no recommendation. The APTA guideline calls it best practice, on expert opinion. Staying active before surgery is sensible, but it hasn't been tested.

Sources 4, 13

For life: lighter weights and more repetitionsEmerging evidence

ASES advises light weights and more repetitions, 2 to 3 times a week, and avoiding push-ups, bench press and heavier overhead lifting, especially after a reverse replacement. Surgeons' weight limits after a reverse replacement range from as much as is comfortable to about 9 kg (20 lb), and there is generally no limit after an anatomic one. ASSET found no agreement on a lifelong limit, and advises against bench press, chopping wood and swinging a sledgehammer after an anatomic replacement. This is expert advice rather than trial evidence.

Sources 11, 10

How much pain is OK while you exercise?

Don't force it early; later, a mild ache that settlesEmerging evidence

In the sling and assisted-movement stages, move within comfort, and don't force a movement or push into a stretch, as an NHS leaflet puts it. Some aching afterwards is expected. If an exercise brings more pain that isn't eased by rest, painkillers or ice, stop it and ask your team (another NHS hospital's rule). ASSET moves people on from the first stage when pain with assisted movement is under 3 out of 10.

Once you're lifting the arm yourself and building strength, a mild ache of up to about 3 out of 10 that settles within an hour or so, and is no worse the next morning, is fine. The 3 out of 10 figure borrows ASSET's guide, and the settling times are editorial, not a tested rule.

A sharp catch, a clunk, the feeling of the shoulder slipping, or pain that builds from week to week means stop that exercise and tell your team.

Sources 33, 34, 10

The exercise plan: 4 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

In the sling: hand, elbow, neck and posture (from the day of surgery, as your team allows)

As your team allows, from the day of surgery. Wear the sling as your team says, taking it off to wash and exercise; NHS hospitals' plans range from 2 days, then as comfort allows, to 6 weeks. Keep the hand, wrist, elbow and neck moving, and sit tall. To wash under the arm, rest the hand on a table or sink so the arm is supported. Ice for up to 15 to 20 minutes at a time, wrapped in a damp towel, a few times a day. Walk every day, and keep to your precautions.

Ball squeeze demonstrated on the 3D figure

3D demoBall squeezeBeginner · Other / check instructions

10 squeezes of a sponge or soft ball, 3 times a day · The sling can stay on. One NHS hospital's dose

Harder: Band finger extension

Wrist & forearm flow demonstrated on the 3D figure

3D demoWrist & forearm flowBeginner · No equipment

Bend the wrist, circle it, and turn the palm up and down, 10 of each, 3 times a day · With the elbow bent at your side. NHS leaflets' exercises and dose

Harder: Wrist flexor stretch

Elbow bend and straighten (elbow range of motion) demonstrated on the 3D figure

3D demoElbow bend and straighten (elbow range of motion)Beginner · No equipment

10 times, 3 times a day · The good hand can help; keep the upper arm by your side. An NHS leaflet's dose

Harder: Dumbbell biceps curl

3D demoNeck CARsBeginner · No equipment

Gentle nods and side tilts rather than full circles, 10 of each, 3 times a day · An NHS leaflet's neck exercises

Seated upper-back lift (sit tall, shoulders back) demonstrated on the 3D figure

3D demoSeated upper-back lift (sit tall, shoulders back)Beginner · A bench or box

Draw the shoulder blades gently back and down and hold 10 s, 10 times, 3 times a day · The operated arm stays resting in the sling or on a pillow, and the elbow doesn't go behind your body. An NHS leaflet's posture exercise

Easier: Elbows back · Harder: Prone Y-T-W raises

Pendulum exercise (Codman's pendulum) demonstrated on the 3D figure

3D demoPendulum exercise (Codman's pendulum)Beginner · A bench or box

Only if your team includes it: small circles, 20 each way, leaning on a table with the good hand · Some hospitals leave pendulums out for the first 3 weeks after a reverse replacement. An NHS leaflet's dose

Harder: Table slide (seated forward reach)

Move on when: Your team says assisted shoulder movement can start: from the first days to 3 weeks after the operation in NHS hospitals' plans.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Assisted movement within your limits (as your team allows)

As your team allows. Let a table or your good arm do the work, inside the limits your team set: for example, below shoulder height for the first 3 weeks after a reverse replacement in one NHS hospital, or no higher than pointing at the ceiling from 1 week after an anatomic replacement in another. Don't force a movement or push into a stretch. After a reverse replacement, keep the elbow where you can see it. Many NHS leaflets also use a lying arm raise, with the good arm lifting both; the 3D figure doesn't show it yet, so the table slide stands in for it here, and its steps are in the notes below.

Table slide (seated forward reach) demonstrated on the 3D figure

3D demoTable slide (seated forward reach)Beginner · A bench or box

10 slow slides, 3 times a day, with a cloth under the hand and no weight through the arm · Standing in for the lying assisted arm raise. An NHS leaflet's dose

Easier: Pendulum exercise (Codman's pendulum) · Harder: Overhead lat stretch at a bench

Stick-assisted external rotation (lying) demonstrated on the 3D figure

3D demoStick-assisted external rotation (lying)Beginner · Other / check instructions

10 slow repetitions, 3 times a day, with the elbow tucked in on a folded towel · Only to your team's limit: often 30° after an anatomic replacement, and some reverse replacement plans allow no turning out past pointing straight ahead at first. An NHS leaflet's dose

Harder: Standing band external rotation

3D demoSeated upper-back lift (sit tall, shoulders back)Beginner · A bench or box

Continue: hold 10 s, 10 times, 3 times a day

Easier: Elbows back · Harder: Prone Y-T-W raises

3D demoBall squeezeBeginner · Other / check instructions

Continue: 10 squeezes, 3 times a day

Harder: Band finger extension

3D demoPendulum exercise (Codman's pendulum)Beginner · A bench or box

Continue if your team includes it: small circles, 20 each way

Harder: Table slide (seated forward reach)

Move on when: Your team allows you to start lifting the arm yourself, usually around 6 weeks. ASSET's guide for moving on is pain under 3 out of 10 with assisted movement, and the sling off.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Lifting the arm yourself, and gentle strength (often from about 6 weeks, as your team allows)

As your team allows, often from about 6 weeks. Lift the arm yourself, starting lying down with the arm pointing at the ceiling, where gravity helps, then propped up on pillows, then sitting and standing, with the elbow bent before straight. Gentle holds against a door frame can start if your team gives them (steps in the notes below). Keep daily tasks light, below shoulder height and in front of you. Still no stretching the hand up your back, and no pushing up through the arm, until your team says.

Dumbbell shoulder-blade punch demonstrated on the 3D figure

3D demoDumbbell shoulder-blade punchBeginner · A dumbbell + A bench or box

No weight at first: lying back with the arm pointing at the ceiling, reach the hand a little higher, then lower it, 10 times, twice a day · The lying start of the lifting progression in the ASSET consensus and the SHORT trial plan; the dose is editorial

Harder: Scapular push-up (push-up plus)

Breath reach demonstrated on the 3D figure

3D demoBreath reachBeginner · No equipment

5 slow breaths, the arms rising only as high as is comfortable and your team allows

Scaption raise demonstrated on the 3D figure

3D demoScaption raiseBeginner · A dumbbell

No weight, thumbs up, to shoulder height only, 10 times, once or twice a day · Editorial dose

Easier: Band lateral raise · Harder: Smith machine upright row

Side-lying external rotation demonstrated on the 3D figure

3D demoSide-lying external rotationBeginner · A dumbbell

No weight at first: operated arm on top, elbow on a folded towel against your side, 10 slow repetitions, once or twice a day · After an anatomic replacement, only within your team's outward-turning limit. Editorial dose

Easier: Standing band external rotation · Harder: Cuban rotation

3D demoBand rowBeginner · A band + An anchor point

Lightest band, 2 sets of 10, every other day · The elbows stop at your sides; after a reverse replacement, not behind your body until your team allows. Editorial dose

Harder: Supported single-arm dumbbell row

Tandem stance and heel-to-toe walk demonstrated on the 3D figure

3D demoTandem stance and heel-to-toe walkBeginner · A wall

Beside a counter with the good hand on it: hold 20 s with each foot forward, then 3 walks of 15 steps · Balance work, because falls after the operation are common

Easier: Semi-tandem stance · Harder: Single-leg stand

Move on when: You can lift the arm to about shoulder height smoothly, without hitching the shoulder up, and your team agrees. ASSET's guide is active movement close to the movement you have with help, without pain.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 4

Strength for the long term (often from about 12 weeks, as your team allows)

As your team allows, often from about 12 weeks. Build strength slowly with light weights or bands and more repetitions, 2 to 3 times a week, keeping loads below shoulder height and in front of you at first. Plan sport with your team: in NHS hospitals' plans, breaststroke from 6 to 8 weeks, front crawl and golf from about 3 months, contact sport from 3 to 6 months. For life, avoid heavy overhead lifting, bench press and push-ups, especially after a reverse replacement.

Standing band external rotation demonstrated on the 3D figure

3D demoStanding band external rotationBeginner · A band + An anchor point

Lightest band, elbow tucked in, 2 to 3 sets of 10 to 15, 2 to 3 times a week · Light load and more repetitions, as ASES and ASSET advise; the set numbers are editorial

Harder: Side-lying external rotation

Band internal rotation demonstrated on the 3D figure

3D demoBand internal rotationBeginner · A band + An anchor point

Lightest band, 2 to 3 sets of 10 to 15, 2 to 3 times a week · After an anatomic replacement, only once your team allows resisted turning in, not before 6 weeks

Harder: Side-lying external rotation

3D demoBand rowBeginner · A band + An anchor point

2 to 3 sets of 10 to 15 with a light band, 2 to 3 times a week

Harder: Supported single-arm dumbbell row

3D demoScaption raiseBeginner · A dumbbell

0.5 to 1 kg, to shoulder height, 2 sets of 10 to 15 · After a reverse replacement, the SHORT trial plan keeps weights for lifts like this to about 1.4 kg (3 lb) or less

Easier: Band lateral raise · Harder: Smith machine upright row

3D demoDumbbell shoulder-blade punchBeginner · A dumbbell + A bench or box

0.5 to 1 kg, 2 sets of 10 to 15 · Editorial weight

Harder: Scapular push-up (push-up plus)

Wall push-up demonstrated on the 3D figure

3D demoWall push-upBeginner · A wall

Only if your team agrees: hands at chest height, a small range, 2 sets of 10 · ASES advises against full push-ups. Editorial dose

Harder: Push-up

Move on when: This is the long-term programme. Add repetitions before weight, keep weights light, and check any new sport or heavy task with your team first.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Typical precautions, which your team may change

These are typical precautions in NHS hospital protocols and US guidance; yours may differ, and your own team's list comes first. Most last about 6 weeks, or as your team advises.

After a reverse replacement, for example: no hand behind your back (tucking in a shirt, washing your back, reaching a back pocket), no reaching behind you or across your body, keep the elbow where you can see it, and no pushing up from a chair or bed with that arm.
After an anatomic replacement, for example: turn the arm out only to your team's limit, no pushing, pulling or lifting against turning the arm in, and no pushing up from a chair with that arm.
For both: nothing heavier than a cup of tea or a glass of water in the first weeks, and daily tasks below shoulder height and in front of you.

Sources 6, 9, 7, 1, 3, 8

Typical timings, which your team may change

These come from NHS hospitals' plans, and they differ. Your own team's timings come first.

Sling: from 2 days, then as comfort allows with nights for 3 weeks, to 6 weeks.
Driving: from about 6 weeks after a reverse replacement and 6 to 8 weeks after an anatomic one, once you're out of the sling and can control the car safely. Check with your insurer.
Work: a desk job at about 6 weeks, lighter manual work at about 8 weeks, heavier work as your surgeon advises.
Swimming: breaststroke at 6 to 8 weeks and front crawl at about 3 months, once the wound has healed.
Golf and cycling from about 3 months; contact sport from 3 to 6 months.
Heavy lifting: 3 to 6 months after an anatomic replacement; one NHS hospital doesn't recommend it after a reverse replacement.

Sources 35, 6, 9, 7

The lying assisted arm raise (written steps)

Many NHS leaflets use this as the first arm lift. Do it only when your team includes it, and only to the height they allow. The 3D figure doesn't show it yet; the table slide works the same range sitting up. In muscle measurements cited by ASSET, lifting the arm with the other hand worked the healing tendon at the front less than lifting it with a stick.

1. Lie on your back on a bed with your knees bent and a pillow under your head. Get into position without pushing up through the operated arm.
2. Clasp your hands together on your stomach, or hold the operated wrist with your good hand.
3. Let the good arm slowly lift both hands up towards the ceiling, keeping the operated arm relaxed.
4. Stop at the height your team allows (for example, shoulder height at first, or pointing at the ceiling), short of any stretch, and pause for 2 seconds.
5. Lower slowly. 10 times, 3 times a day, is a common NHS leaflet dose.

Sources 34, 33, 7, 10

Door-frame holds (written steps)

Gentle holds against a door frame keep the shoulder muscles working without moving the joint. One NHS hospital starts them from 1 to 2 weeks after an anatomic replacement; a US trial plan uses similar holds in weeks 3 to 6 after a reverse replacement. Do them only if your team gives them to you.

1. Stand beside a door frame with the operated arm at your side and the elbow bent to a right angle.
2. Turning out: press the back of your hand gently into the frame, as if turning the arm outwards. The arm doesn't move. Hold 5 seconds.
3. Backwards: stand with your back to the frame and press the elbow gently back into it. Hold 5 seconds.
4. Turning in, only once your team allows (after an anatomic replacement, one NHS hospital starts this hold at 2 weeks and another not before 6 weeks): press your palm into the frame as if turning the arm inwards. Hold 5 seconds.
5. Use about a third of your effort, 5 to 10 of each, twice a day. The count is editorial; the leaflet gives none.

Sources 7, 8, 9

Positions to swap, and why

Habit or position	Why it matters	Instead
Putting the hand behind your back, or reaching behind you or across your body (example, after a reverse replacement)	That position is how a reverse replacement dislocates, and typical NHS protocols avoid it for about 6 weeks.	Use the other hand or a long-handled sponge, and keep the operated elbow where you can see it.
Pushing up from a chair or bed with the operated arm (example)	It loads the healing repair and, after a reverse replacement, risks a dislocation; NHS leaflets say not for 6 weeks.	Stand up using your legs, pushing with the good hand only.Try: Sit to stand from a chair
Turning the arm out past your limit, or pushing against turning it in (example, after an anatomic replacement)	It strains the repaired tendon at the front of the shoulder while it heals.	Stay inside the range your team set with the stick.Try: Stick-assisted external rotation (lying)
Lifting more than a cup of tea or a glass of water in the first weeks (example)	NHS and US guidance keep loads tiny while the shoulder heals.	Use the other arm, and keep tasks light, below shoulder height and in front of you.
Cross-body stretches	Reaching across the body is part of the dislocation position after a reverse replacement.	Table slides within your limits.Try: Table slide (seated forward reach)
Forcing a stretch to get the range back	Protocols say don't force it, and the gains from starting harder or earlier are small.	Slow, assisted movement within your limits.Try: Table slide (seated forward reach)
Lying on the operated shoulder in the early weeks	An NHS leaflet advises against it.	Sleep on your back or the other side, with a pillow supporting the operated arm.
Swimming before the wound has healed and your team agrees	ASSET advises no submerging for 4 weeks, and NHS plans allow breaststroke from 6 to 8 weeks and front crawl from about 3 months.	Walking meanwhile.Try: Treadmill walking
Dips, including bench dips	They take your body weight with the hands behind you: the loaded, behind-the-body position an NHS protocol rules out after a reverse replacement because of the dislocation risk.	Leave them out, and ask your team about lighter triceps work.
Push-ups and bench press (long term)	ASES and ASSET advise against them, especially after a reverse replacement.	Light band work below shoulder height, and wall push-ups only if your team agrees.Try: Standing band external rotation

Routines to follow

Easy cardio workout

A steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.

40 minBeginner3 movesCardio machine, A wall

Balance exercises routine

Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.

10 minBeginner7 movesA wall, A bench or box

Chair exercises for seniors: a seated workout

A 20-minute seated workout for older adults who cannot stand for long: marching, leg and arm strength, posture, and sit-to-stands that lead back to standing.

20 minBeginner11 movesA bench or box, Something with weight

More moves for this area

Questions people ask

How long is recovery after a shoulder replacement?

Most people have useful movement by about 3 months, and the shoulder keeps improving for 1 to 2 years. Driving and desk work usually come back from about 6 weeks, and golf and front crawl from about 3 months, but your team's timings come first.

What exercises should I do in the first weeks?

From the first day: hand squeezes, wrist and elbow movements, gentle neck movements and sitting tall with the shoulder blades drawn back, about 10 of each, 3 times a day. Your team adds assisted shoulder movement, such as a table slide or lifting the arm with your good hand, when it's safe for your kind of replacement.

What's the difference between a reverse and an anatomic shoulder replacement?

An anatomic (total) replacement copies the normal joint and needs a working rotator cuff. A reverse replacement swaps the ball and socket so the deltoid can lift the arm when the cuff is torn. That's why the precautions differ: a reverse one is protected from the hand-behind-the-back position, an anatomic one from straining the repaired tendon at the front.

What should I avoid after a reverse shoulder replacement?

Typical precautions in NHS hospital protocols, for about 6 weeks or as your team advises, are no hand behind your back, no reaching behind you or across your body, no pushing up from a chair with that arm, and nothing heavier than a cup of tea. Long term, avoid heavy overhead lifting, push-ups and bench press. Your own team's list comes first.

How long will I wear a sling?

It depends on your hospital: from 2 days, then as comfort allows, to 6 weeks in NHS plans. No length has been shown to be best, and after a reverse replacement a trial found no sling did as well as 3 weeks in one, so follow your team.

How should I sleep after a shoulder replacement?

Wear the sling at night if your team asks, and don't lie on the operated shoulder in the early weeks. Many people find sleeping on their back or propped up, with a pillow under the operated arm, most comfortable.

Do I need physiotherapy, or can I do the exercises at home?

After a reverse replacement, three trials found a home programme taught by the surgical team worked as well as clinic physiotherapy. There are no such trials after an anatomic replacement. Either way, ask for supervised physiotherapy if you're struggling, stuck or unsure you're doing it right: NICE says it should be offered then.

When can I drive after a shoulder replacement?

Usually from about 6 weeks after a reverse replacement and 6 to 8 weeks after an anatomic one, once you're out of the sling and can control the car safely. Check with your team and your insurer.

Can I play golf or swim again?

Most people can: in reviews, about 80% of golfers returned after a shoulder replacement, and NHS plans allow breaststroke from 6 to 8 weeks and front crawl from about 3 months. Fewer people return after a reverse replacement than after an anatomic one, so plan it with your team.

Can a shoulder replacement dislocate?

Yes, mainly a reverse replacement, in about 2.5% of cases, usually in the first 3 months. A sudden clunk with pain, a changed shape or an arm you can't move needs A&E. Keeping to the precautions lowers the risk.

Is new pain months after a reverse replacement normal?

Some aching while you build strength is normal. New pain over the top of the shoulder with trouble lifting the arm, after a spell of doing well, can be a stress fracture of the acromion, so tell your team. New or worsening pain years later should be referred back to your surgeon.

Can I lift weights again after a shoulder replacement?

Yes: light weights with more repetitions, 2 to 3 times a week, are encouraged for the long term. Avoid heavy overhead lifting, bench press and push-ups, especially after a reverse replacement. Some surgeons set a weight limit and others don't, so ask yours.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.