Physical therapy after shoulder surgery

Author: Erik Versluis, Physiotherapist
Published: 23-07-2025
⏳ Estimated reading time: 5 minutes

A shoulder surgery is often necessary in cases of severe injuries, degeneration, or joint instability. Proper physiotherapy guidance is crucial for a full recovery and the restoration of shoulder function.

In this article, I will outline the most common types of shoulder surgeries, explain the role of physiotherapy in the rehabilitation process, and describe what to expect during recovery.

Common types of shoulder surgery

Surgeons perform different types of shoulder operations depending on the nature of the injury or condition. Surgery is usually indicated when natural healing is not possible, and symptoms persist despite conservative treatment.

1. Rotator Cuff repair

The rotator cuff is a group of muscles and tendons that stabilize the shoulder and assist with arm movements. When one or more of these tendons are torn, surgery may be required to restore shoulder function. This procedure is mostly performed in younger individuals (typically under 55).

2. Shoulder replacement (Arthroplasty)

In cases of severe joint degeneration, complex tendon tears, or serious fractures, a surgeon may recommend a shoulder prosthesis. The artificial joint replaces the damaged one and is often indicated for people with long-term pain and movement restriction.

3. Bankart Repair (for Shoulder Instability)

Bankart repair is used to treat shoulder instability, commonly caused by recurrent dislocations. During surgery, the torn labrum and joint capsule are repaired to restore joint stability.

4. Subacromial decompression

In this procedure, the surgeon removes inflamed or excess tissue and bone from the subacromial space to create more room in the shoulder. It is often performed for shoulder impingement syndrome, where tendons are believed to be compressed.

Note: This surgery is now performed less frequently. Scientific studies have shown that physiotherapy alone often yields similar long-term results. Increasingly, shoulder pain and bursitis are thought to be caused not by lack of space, but by overuse, movement dysfunction, and aging.

Why physiotherapy is crucial after shoulder surgery

Physiotherapy plays a vital role in recovery after shoulder surgery. Multiple scientific studies support its importance. The goal of rehabilitation is to gradually restore strength, mobility, and function while protecting the healing tissues.

Phases of rehabilitation

1. Early phase: passive movement only

In the early phase, the focus is on restoring range of motion without loading the joint. Your physiotherapist will guide you through passive movements to prevent stiffness. This phase typically lasts 4 to 6 weeks, depending on the type of surgery.

2. Strengthening and mobility

The second phase focuses on strengthening the shoulder muscles and improving mobility. You will begin active exercises but must remain cautious to avoid overuse. This stage may take several months, and your therapist will adapt the pace to your individual recovery.

3. Functional recovery and coordination

The final phase targets full return of function. You will gradually resume daily activities and possibly sports. Advanced exercises are introduced to improve shoulder strength, endurance, and coordination.

Your treatment plan will be tailored to your goals and lifestyle.

Recovery expectations after shoulder surgery

Recovery outcomes vary depending on the injury, the type of surgery, and your commitment to rehabilitation. Below are general timelines:

• Rotator Cuff Repair: Recovery may take 6 to 12 months. Most regain full strength and function if rehabilitation is followed diligently.

• Shoulder Replacement: Significant improvement in pain and mobility is usually seen after 6 months. Full recovery can take up to 12 months.

• Bankart Repair: Most people return to normal activities within 3 to 6 months. Full joint stability may take slightly longer.

• Subacromial Decompression: Recovery is usually quicker—about 3 to 4 months—since the procedure involves tissue cleaning rather than structural repair.

Tips for a successful recovery

• Follow your physiotherapist’s advice: Each phase is essential. Perform your exercises correctly and at the recommended pace.

• Be patient: Recovery takes time. Rushing the process can delay healing or lead to complications.

• Listen to your body: Mild discomfort is normal, especially early on. Persistent or worsening pain may indicate overuse.

Conclusion

Physiotherapy after shoulder surgery is essential for a successful recovery. The type of surgery partly determines the rehabilitation timeline and outlook, but with professional guidance and commitment, most shoulder functions can be fully restored.

If you are preparing for shoulder surgery or have recently undergone one, speak with your physiotherapist about a personalized rehabilitation plan that suits your condition and goals.