Reverse replacement and I can lift overhead fine now but still can't reach behind my back. Is that limit permanent?

Right, about five months on from my reverse now and I need a straight answer from people further down the road than me. The lifting has come back brilliantly, honestly better than I dared hope. I can reach the top kitchen cupboard, get a full watering can up, hang a coat on a high hook, all the stuff the deltoid is supposed to give you. Genuinely made up with that side of it.

BUT. I still cannot get my hand round behind my back. Tucking a shirt in, reaching my back trouser pocket, doing up an apron string, none of it. The arm just will not rotate inward past a certain point and it stops dead. It is not even sore, it just refuses to go. Nobody warned me the two things would come back so differently, I assumed once the strength arrived the reach would follow.

So the questions I cannot get answered plainly. Is the behind the back movement gone for good after a reverse, or does it keep creeping back? Why is that one so much worse than the overhead lifting? And is there anything the physio can actually do for it, or is this just how a reverse ends up? I can live with it if someone tells me it is normal, I just want to stop wondering if I should be pushing harder.

Derek this is my exact shoulder. Overhead and out to the side, superb. Round the back, no. I do my trousers up at the front and then turn them round, I have my own little system for everything now. What I will say is the overhead being the thing that came back strongest is the whole point of the reverse, it is built to give you that. The reaching in behind you is the movement that tends to stay parked. Knew it going in so it never upset me, but I understand why it is throwing you.

Worth adding a different data point so you can see it is the operation and not you. I had an anatomic total, cuff was intact, and my behind the back reach actually came back pretty well, I can just about get to my mid back. The difference is not that you did the rehab wrong, it is that a total keeps the natural setup so the inward rotation is more available, whereas a reverse changes the geometry to hand the lifting to the deltoid and that inward reach is the bit it tends to trade away. Different operations, different movement afterwards. You got the one your cuff needed.

Taking the main question first: yes, this pattern is normal and expected after a reverse, and no, it usually does not mean anything has gone wrong. Forward elevation, lifting the arm up and out in front, is the movement a reverse restores most reliably, because switching the ball and socket lets the powerful deltoid drive the arm. Internal rotation, the reaching behind the back, is the movement that most commonly stays limited after a reverse, and it is a recognised trade of that changed geometry rather than a failure of your rehab.

A few honest specifics on top of that. Range tends to keep improving across roughly the first 6 to 12 months, so at five months you may not have finished gaining, and it is reasonable to keep working at it. That said, some inward reach staying permanently restricted is common after a reverse, and many people end up adapting the way reverse-at-68 describes rather than getting every last degree back. The comparison keencaravanner draws is a fair one: an anatomic total generally preserves more internal rotation, which is one reason the type is matched to the joint rather than one being simply better. Our page on what movement is realistic after each type sets out why the cuff and the operation set your ceiling, and how a reverse actually works explains the deltoid trade in plain terms.

As for what physio can do, a therapist can work on the inward rotation you do have and on the workarounds, but they cannot push a reverse past the limit its geometry sets. Whether you have more to gain, and how hard to chase it, is a call for the physiotherapist and surgeon who can actually examine your shoulder and know how yours was built, not something to judge from a thread.

That is exactly what I needed, cheers. Reading that the overhead coming back strongest IS the reverse doing its job, and the behind the back being the bit it trades, has completely settled me. I will keep at the physio for a few more months in case there is a bit more in it, but I am going to stop treating it like a fault. The lifting was the thing I actually wanted back and I have got that.