Shoulder Surgeries Treated by Physical Therapy

If you have shoulder pain, you know how this can limit your ability to reach for things. You may be having a difficult time performing basic tasks like bathing, dressing, or combing your hair because of the pain.

You may be referred to physical therapy to help decrease your shoulder pain and improve your range of motion and strength in your arm. Sometimes, the damage to your shoulder is too great, and physical therapy is unsuccessful in restoring normal function to your painful shoulder. You may require shoulder surgery to help return to normal.

After shoulder surgery, you may experience a period of immobilization. Your healthcare provider may have you wear a sling to protect your shoulder as it heals. During this time, the muscles around your shoulder may become weak, and structures near your shoulder may become tight.

Physical therapy may be necessary to return to normal function after shoulder surgery. It is important to know exactly what surgery was performed so that your rehabilitation program is tailored to your exact needs.

Below is a list of common shoulder operations that may require the skilled services of a physical therapist to help rehabilitate. If you have shoulder surgery, be sure to ask your healthcare provider if physical therapy can help you improve the function and mobility of your shoulder and arm once the operation is done.

1

Rotator Cuff Repair

Young woman feeling pain in her shoulder
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The rotator cuff muscles are a group of four muscles that lie deep in your shoulder and help control the position of your shoulder as you move your arm. Sports injuries, trauma, or simple wear and tear may cause these muscles to fray and tear.

Rotator cuff repairs can be done arthroscopically or via an open procedure. After a rotator cuff repair, physical therapy may be necessary to help improve the range of motion and strength of your shoulder.

You can expect to work with your physical therapist (PT) for four to six weeks (maybe longer) after a rotator cuff repair. Your PT can teach you exercises to do to maintain long-term gains and function in your arm.

2

Labrum Repair

The labrum is a small piece of tissue that courses around the rim of the socket in your shoulder. It can become torn if subjected to trauma like a fall or a sports injury. Tears to the labrum may cause shoulder instability or frequent shoulder dislocations.

Different parts of the labrum can be torn. A tear in the front of your shoulder is called a Bankart tear. A tear on the top of the labrum is called a SLAP (superior labrum, anterior to posterior) tear. Often a SLAP tear involves repair of the biceps tendon, which attaches there.

Surgery to repair your torn labrum may be necessary to stabilize your shoulder joint. Physical therapy after the surgery may be needed to ensure safe return to normal arm use and mobility.

3

Subacromial Decompression

If you are having shoulder impingement symptoms that are not resolved by conservative measures like physical therapy, then you may require a subacromial decompression. This surgery gives extra room to the rotator cuff tendons. It might involve removing part of the subacromial bursa, which cushions the shoulder joint.

Many patients do well after this surgery with no physical therapy, but sometimes therapy is necessary to improve shoulder range of motion and strength after the procedure.

4

Total Shoulder Replacement

If you suffer from arthritis of the shoulder and have failed to improve your arm function with conservative measures like physical therapy, then your surgeon may perform a total shoulder replacement. This surgery requires that the surgeon remove your arthritic shoulder joint and replace it with an artificial one.

The two most common shoulder replacement surgeries are the total shoulder replacement and the reverse total shoulder replacement. Your shoulder physical therapy and rehabilitation will differ significantly depending on which procedure you had done.

5

Fracture Repair

If you have had the unfortunate event of breaking a bone in your shoulder, then your surgeon may have to perform an open reduction internal fixation (ORIF) to repair the bone. Commonly, collarbone fractures and proximal humeral fractures require ORIF, and physical therapy may be needed to improve the range of motion and strength around your shoulder after the procedure.

6

Shoulder Manipulation Under Anesthesia

If you have a frozen shoulder that is not responding to an aggressive range of motion exercises, then your healthcare provider may perform a manipulation under anesthesia (MUA). Although this is not a true surgical procedure and no cut is made in your body, you will be put under anesthesia. Your shoulder will be forcefully brought through its range of motion.

Physical therapy after the MUA procedure is necessary to maintain the range of motion gained by the procedure to help keep your shoulder moving.

7

Biceps Tendon Repair

A biceps tendon rupture often does not limit the functional mobility of your shoulder or arm, but it can make your upper arm look disfigured. Some people want to have the biceps tendon repaired as a result. Physical therapy may be needed after the procedure to ensure the return to normal arm use after the surgery.

A Word From Verywell

If you have had shoulder surgery, you may benefit from the skilled services of a PT to help you regain motion and strength in your arm. By working with a PT, you can be sure to quickly and safely return to your previous level of function and activity.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Thigpen CA, Shaffer MA, Gaunt BW, Leggin BG, Williams GR, Wilcox RB. The American Society of Shoulder and Elbow Therapists’ consensus statement on rehabilitation following arthroscopic rotator cuff repair. J Shoulder Elbow Surg. 2016;25(4):521-535. doi:10.1016/j.jse.2015.12.018

  2. Aydin N, Sirin E, Arya A. Superior labrum anterior to posterior lesions of the shoulder: diagnosis and arthroscopic management. World J Orthop. 2014;5(3):344-350. doi:10.5312/wjo.v5.i3.344

  3. Vandvik PO, Lähdeoja T, Ardern C, et al. Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline. BMJ. 2019;364:l294. doi:10.1136/bmj.l294

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.