How long will I need a sling? When can I shower? Will I need physical therapy?
These are common questions when planning shoulder replacement surgery. Knowing the timeline can help you arrange transportation, prepare your home, and understand what to expect at each appointment.
Below is the typical recovery plan in my practice. Some instructions differ between anatomic shoulder replacement and reverse shoulder replacement. Your individual instructions take priority if we adjust the plan for your surgery.
The first three weeks: protecting your shoulder
After either type of shoulder replacement, you will initially wear a sling with a supporting pillow. Wear the sling while sleeping, but you can take breaks while sitting in a quiet environment.
You can use your hand for light daily activities such as eating, typing, and basic personal care. Think holding a cup of coffee, rather than lifting groceries or doing household chores. Being able to use your hand does not mean your shoulder is ready for unrestricted activity.
Keep your hand, wrist, and elbow moving throughout recovery. Gentle pendulum exercises are also allowed. We will guide you on when to add other shoulder exercises.
Showering and dressing care
You may shower right away with your waterproof dressing in place. Leave the dressing alone until your three-week appointment.
If the dressing loosens, leaks, or allows water underneath, contact the office for instructions rather than waiting for your scheduled visit.
Managing pain
We use a multimodal pain-management approach, including a nerve block and medications that work in different ways to control discomfort. Follow your discharge instructions for how and when to take each medication.
The goal is to make recovery manageable. Contact the office if your pain is not adequately controlled or you have questions about your medications.
Your three-week appointment
Your first routine follow-up is with a nurse practitioner or physician assistant. At this visit, we check your incision, review your recovery, and remove the sling pillow.
What happens next depends on your replacement:
Reverse shoulder replacement: You discontinue the sling altogether at three weeks.
Anatomic shoulder replacement: You continue wearing the sling for another three weeks, but without the pillow.
For anatomic replacement, continue wearing the sling while sleeping during this period. Brief breaks while sitting quietly are still okay.
Weeks three through six
After a reverse replacement, coming out of the sling is an important milestone, but it does not mean the shoulder is ready for unrestricted use. Continue light daily activities and the permitted early exercises. Your structured home shoulder exercise program begins at six weeks.
After an anatomic replacement, continue using the sling without its pillow until the six-week visit. Formal physical therapy starts at six weeks.
For both procedures, continue hand, wrist, and elbow range of motion throughout this period.
When can I drive?
In my usual protocol, driving can resume once the sling has been discontinued—typically at three weeks after reverse replacement and six weeks after anatomic replacement.
You must also be off opioid pain medication and other medications that impair alertness, and be able to control the vehicle safely. Taking a brief break from the sling does not mean you are ready to drive.
Your six-week appointment
At six weeks, you will see a nurse practitioner or physician assistant and have X-rays taken. We will review your progress and discuss the next stage of recovery.
For anatomic shoulder replacement, this is when you discontinue the sling and begin formal physical therapy.
For reverse shoulder replacement, this is when you begin your home exercise program. In my practice, formal physical therapy is rarely needed after reverse replacement, although we can add it when appropriate for an individual patient.
Starting rehabilitation does not mean jumping straight into heavy lifting or unrestricted exercise. Follow the program and activity limits provided by your care team.
Your recovery timeline at a glance
MilestoneAnatomic replacementReverse replacementFirst three weeksSling with pillowSling with pillowThree-week NP/PA visitWound check; remove pillow; continue slingWound check; discontinue sling and pillowWeeks three through sixSling without pillowNo sling; continue permitted light activitiesSix-week NP/PA visit with X-raysDiscontinue sling; begin formal PTBegin home shoulder exercise programThree-month visitFollow-up with meFollow-up with meOne-year visitFollow-up appointmentFollow-up appointment
Hand, wrist, and elbow motion, gentle pendulums, and permitted light daily activities are part of recovery for both procedures.
Beyond the first six weeks
The six-week visit marks a transition in recovery, not the finish line. Your next appointment is with me at three months, followed by a one-year appointment.
You do not need to wait for a scheduled visit if a concern comes up. Contact the office with questions about your incision, pain, exercises, or activity restrictions.
Understanding the plan ahead of time makes it easier to prepare—and helps you focus on the right steps at each stage of recovery.
