The other day a patient asked me if he should exercise his shoulder before getting a shoulder replacement. A little background, the patient is about 60 years old and is an avid weight lifter. I was a little confused by the question so I asked him to clarify.
He thought that if he increased his shoulder and chest strength before surgery, this would make it easier for him to recover and for me to do the surgery.
I don’t know if his first point is true or not but I can assure you that operating on a more muscular individual is more challenging than a less muscular one. I can do it. In fact the other day I did a revision shoulder replacement on a stocky 5′ 5″ 250 lb man. But it’s more time consuming and technically challenging because patients with that build usually have thick, tight muscle that makes exposure of the shoulder more difficult.
So I can’t recommend bulking up before shoulder replacement as a good strategy for making the whole process easier.
What I can say is that learning how to use your opposite arm, getting used to wearing loose fitting clothes and figuring out how to do things one handed before surgery will likely help you considerably. You will need these skills, or at least some trusted help, in the initial 6-8 weeks after shoulder replacement as it is necessary to wear a sling and have very limited weight bearing in the operative arm.
Strengthening your core (low back and abdominals) and getting in good aerobic shape can help you get through the post operative recovery period in a smoother fashion also.
Core strength will help with bending and torso control for one armed lifting and moving in and out of chairs/ bed. Aerobic conditioning is a benefit for anyone’s endurance after surgery.
Should you do therapy on your shoulder before getting surgery to somehow loosen it up or prepare for the therapy you will do after surgery?
This sounds like a good idea but is just not feasible nor productive for most patients. Most patients just hurt too much before surgery and this type of therapy just aggravates things further in end stage arthritis. So I don’t typically recommend it out of practicality.
When you are planning for shoulder surgery, focus more on your home environment, support structure (family, friends, rehab plans), living arrangements, work situations, and any practical modifications you can make to your surroundings that might make living “one armed” for awhile more pleasant. You may practice wearing a sling for a few days and see what limitations it imposes.
Here is a very thorough description of some things that one patient found helpful to prepare for a shoulder surgery.