Preparing for Shoulder Replacement Surgery: The Weeks Before the Operation

Preparing for a shoulder replacement is mostly practical rather than medical: the hospital handles the fitness checks, and your job is to get the house, the wardrobe, the sleeping arrangement, and the help organised before an arm you rely on spends roughly 2 to 6 weeks in a sling.¹ The people who cope best in the first fortnight are the ones who did this work in advance, because doing it one-handed and sore is miserable.

I prepared for my own reverse replacement by reading everything about the operation and almost nothing about the fortnight after it, which is precisely the wrong way round. I came home to a house arranged for a man with two working arms. This is the plain list I wish someone had handed me, checked by a consultant shoulder surgeon, sitting alongside the week-by-week recovery and the pillar on shoulder replacement.

The medical preparation the hospital does

Before the operation you will have a pre-operative assessment, which checks you are fit for a general anaesthetic and goes through your medicines, your existing conditions, and anything that should be settled before an implant goes in.² Expect health questions, blood tests, and a review of everything you take, prescribed or otherwise, since some medicines are paused around surgery.

Two things are worth raising yourself rather than waiting to be asked. The first is any current infection, dental trouble, or broken skin near the shoulder, because a foreign implant and an active infection are a poor combination and teams prefer to clear these first. The second is your anaesthetic: a shoulder replacement is usually done under a general anaesthetic, very often combined with a regional nerve block that numbs the shoulder afterwards, and if you have had a bad experience with anaesthetics before, the pre-op clinic is where to say so.³ The detail sits in shoulder replacement anaesthesia.

Getting the answers you need before the day

Ask which operation is planned and why, and get the sling and physiotherapy protocol in writing, because a total, a reverse, and a partial replacement do not share the same rules.⁴ A reverse replacement is often out of the sling sooner and leans on the deltoid in rehabilitation; an anatomic total protects a healing rotator cuff and is stricter early on. Knowing which set of rules applies to you removes most of the confusion of the first fortnight.

The other questions worth settling in advance are when you can drive, when you can go back to your particular kind of work, who provides your physiotherapy and when the first appointment is, and what the surgeon expects the arm to do at six months rather than what they hope. The fuller list is in questions to ask before shoulder replacement. Write the answers down, because you will not remember them afterwards.

Setting up the house

The single most useful thing you can do is move everything you use daily down to waist height, so that nothing routine requires a reach above your head or a two-handed lift.⁵ Kettle, mugs, plates, cereal, medication, chargers, the lot. If it lives on a high shelf, it may as well live in another building for the next month.

A few other changes earn their place. Clear the floor of anything you might trip on, since falling onto a fresh replacement is exactly the kind of accident that causes a break around the implant. Put a long-handled grabber where you will actually use it. Swap a heavy kettle for a light one you can fill and pour with one hand, and get a jar opener that grips on the worktop. Batch-cook and freeze what you can, because one-handed cooking is slow and tiring in a way that surprises people. If you live alone, arrange for someone to be around for at least the first few days, and think honestly about washing and dressing.

Clothes, washing, and dressing one-handed

Buy or set aside loose, front-fastening tops and slip-on shoes before you go in, because the operated arm goes into a sleeve first and anything that has to come over your head is a struggle for weeks.² Button or zip fronts, wide sleeves, and soft fabrics are the ones that work. Sports bras and anything that fastens behind the back are not.

Showering is the other thing worth rehearsing. You will be given instructions about keeping the wound dry and about the sling, and a plastic chair or a seat in the shower makes the first weeks far easier. Practise washing under the operated arm using your other hand while the arm hangs, because that is the movement you will be told to use and it feels alarming the first time you do it after surgery.

Sleeping, and why to sort it in advance

Set up your sleeping arrangement before the operation, because most people spend the early weeks propped up rather than lying flat, and discovering that at two in the morning on day one is no fun.³ A stack of pillows, a foam wedge, or a recliner chair are all common solutions, and which one suits you is worth testing while you can still move freely.

Ironically, this was the part I was least worried about and it mattered most. I had spent two years sleeping badly because of the shoulder in the first place, so I assumed the post-operative version could not be worse. It was different rather than worse, and the propped-up setup made it tolerable. The full account of what those nights are actually like is in sleeping after shoulder replacement.

Physiotherapy, and whether to start before

Learn the early exercise routine before the operation rather than after it, because you will be taught it while sore and groggy, and the first movements start within days.⁶ Passive and pendulum movements come first, active movement follows on the surgeon’s schedule, and strengthening comes last, so what you practise in advance is the shape of the programme rather than any heavy work.

Whether to do pre-operative exercises at all is a question for your own team. Some give a prehabilitation programme; others take the view that an arthritic shoulder is best rested until surgery, and there is no single rule that fits every joint. What is universally useful is getting handy with your non-operated arm: brushing your teeth, making tea, and using cutlery left-handed if you are right-handed, or the reverse. It feels ridiculous and it saves a fortnight of fumbling.

The practical arrangements to make early

Book the lift home, the time off, and the help before the operation, because you will not be driving for around 6 weeks and desk work commonly resumes somewhere between roughly 2 and 6 weeks, with heavier or overhead work waiting 3 to 6 months.¹ Those timings decide how much cover you need at work and how many lifts to appointments you need to arrange.

The stay itself is commonly one to two nights, occasionally a day case for fitter patients, so the bag is small: loose clothes, slip-on shoes, your medicines list, and something to do one-handed. What to expect from the timings at work in detail is in going back to work after shoulder replacement. None of this preparation changes the surgery, but it changes the fortnight afterwards more than anything else you can control, and that fortnight is the one that shakes people. Get the boring things done in advance and you get to spend that time recovering rather than improvising.