Shoulder replacement surgery Physiotherapy Clinic in Muscat is often recommended for individuals with severe shoulder arthritis, chronic joint pain, or irreversible joint damage. It can be a life-changing procedure that alleviates pain and restores mobility. However, successful outcomes aren’t only dependent on the surgery itself. Preparing for a shoulder replacement with a structured physiotherapy plan can make a significant difference in recovery speed, surgical outcomes, and long-term shoulder function. Here’s how physiotherapy plays a vital role in preparing for shoulder replacement surgery and why it should be part of your preoperative plan.

While shoulder replacement surgery can improve quality of life, it is still a major procedure. Preparing your body, specifically your shoulder, through prehabilitation (pre-surgery rehabilitation) helps strengthen the surrounding muscles, increase joint stability, and improve flexibility, making the recovery process easier. Physiotherapy can help prepare your shoulder for the stresses of surgery and build physical resilience, giving you a head start on postoperative recovery

Physiotherapy before shoulder replacement surgery offers a range of benefits:

1. Strengthening Shoulder Muscles: Physiotherapy exercises target the rotator cuff, deltoid, and scapular muscles, building strength around the joint, which enhances shoulder stability.

2. Improving Range of Motion: Gentle stretching and mobilization exercises increase shoulder flexibility, helping to retain as much range of motion as possible before surgery.

3. Pain Management: Physiotherapy introduces pain management techniques, such as heat or ice therapy, to help patients manage discomfort leading up to surgery.

4. Education on Post-Surgery Exercises: Learning exercises in advance helps patients understand how to perform them correctly, giving them confidence in performing these exercises post-surgery.

5. Boosting Overall Fitness: Stronger muscles and better conditioning improve circulation, enhance healing, and reduce the risk of post-surgical complications.

Below are some commonly recommended exercises. Always consult with a physiotherapist before beginning any pre-surgery exercise program, as they can customize exercises based on your specific condition and needs.

1. Pendulum Exercise

Pendulum exercises help maintain shoulder movement with minimal stress on the joint.

• How to Do It: Lean forward, supporting yourself with one hand on a table or chair, allowing the affected arm to hang loosely. Gently swing the arm in small circles clockwise, then counterclockwise.
• Repetitions: Perform 10-15 circles in each direction, 2-3 times a day.

2. Isometric Shoulder Exercises

Isometric exercises help build muscle strength without moving the joint, ideal for those experiencing pain.

• How to Do It: Stand or sit upright. Press your affected arm against a wall or a pillow, using light pressure without moving your shoulder.
• Examples:
  • Internal Rotation: Press your forearm against a wall or door frame to activate the internal rotators.
  • External Rotation: Place the back of your hand against a wall and push lightly to activate external rotators.
• Hold: Hold each press for 5-10 seconds and repeat 8-10 times.

3. Scapular Squeezes

Scapular squeezes strengthen the muscles that support the shoulder blade, enhancing shoulder stability.

• How to Do It: Sit or stand with your back straight. Gently pull your shoulder blades together, as if trying to pinch them, without raising your shoulders.
• Hold: Hold for 5 seconds and relax. Repeat 10-15 times, 2-3 times daily.

4. Bicep Curls with Light Weights

Strengthening the bicep helps support shoulder movement and can be beneficial after surgery.

• How to Do It: Hold a light weight (or even a can of soup) in your hand, keeping your elbow at your side. Slowly bend your elbow to lift the weight toward your shoulder, then lower it back down.
• Repetitions: Perform 10-12 repetitions on each arm, 2-3 sets.

5. Shoulder Flexion with Wand or Towel

Using a towel or dowel rod, shoulder flexion exercises help increase flexibility in the shoulder.

• How to Do It: Lie on your back with both hands holding the towel or rod in front of you. Gently lift your arms over your head, using your non-affected arm to assist if needed.
• Repetitions: Repeat 10-15 times, ensuring a comfortable stretch each time.

Apart from exercises, physiotherapists may incorporate additional elements to help you prepare for surgery:

1. Posture Training

Good posture can reduce strain on the shoulder joint and support proper alignment. Physiotherapists may introduce posture exercises, helping patients become more aware of shoulder positioning and habits that can relieve pressure on the joint.

2. Breathing Techniques

Learning controlled breathing techniques can help with pain management and anxiety reduction before surgery. Deep breathing exercises can also be useful in managing post-surgery discomfort.

3. Education on Post-Surgical Movements

Your physiotherapist can guide you on using adaptive techniques for daily tasks (like dressing, bathing, and reaching) that will be affected after surgery. Knowing how to move safely and comfortably post-surgery is essential for an easier recovery.

4. Pain Management Techniques

Using heat therapy, cold therapy, and gentle massage before surgery can reduce discomfort and inflammation. Physiotherapists teach patients these techniques, so they know how to manage pre- and post-surgical pain effectively

Besides physical preparation, understanding what to expect on the day of surgery can help alleviate anxiety. Here are some tips:

• Wear Comfortable, Loose Clothing: Clothing that’s easy to remove and accommodates bandages or slings is ideal.
• Arrange for Support: Ask a friend or family member to help with transportation, as you won’t be able to drive yourself post-surgery.
• Bring a List of Medications: Your healthcare team may ask for a list of medications, so it’s helpful to have it ready.
• Discuss Pain Management: Talk to your doctor about postoperative pain management, as they may prescribe medications or suggest additional physiotherapy support.

While preoperative physiotherapy is essential, postoperative physiotherapy is equally important. After shoulder replacement surgery, your physiotherapist will guide you through exercises to restore range of motion, rebuild strength, and regain full function. Postoperative therapy typically includes progressive stretching, strengthening exercises, and gradual return-to-activity plans.

Key Aspects of Postoperative Physiotherapy

1. Range of Motion Exercises: Gentle stretches and movements help prevent stiffness and maintain flexibility.
2. Strengthening Exercises: Targeted strengthening helps stabilize the shoulder joint and supports overall recovery.
3. Pain Management: Your physiotherapist will use various pain management techniques to keep you comfortable and minimize inflammation.
4. Education on Activity Modification: Learning modified techniques for daily activities will help you maintain independence without overloading the healing joint.

Preparing for a shoulder replacement is an essential step in achieving a successful outcome, and physiotherapy plays a crucial role in this process. Through targeted exercises, pain management techniques, and education, physiotherapy helps strengthen the shoulder, improve mobility, and set the foundation for a smoother recovery. By prioritizing preoperative physiotherapy, you’re giving yourself the best chance for a faster, safer recovery after surgery.

If you’re planning for a shoulder replacement, talk to a physiotherapist to develop a personalized prehabilitation plan. With the right guidance and preparation, you’ll enter surgery feeling stronger, more confident, and ready for a successful recovery journey.