Weightlifting is a great way to maintain weight, increase strength, and prevent weight gain. If you have had a total shoulder replacement surgery, then weightlifting may be something that you want to consider or return to.
For some people, weightlifting can even help in the healing process of their shoulder replacement. However, it needs to be performed safely and at the correct point in healing, as lifting too much weight can cause total shoulder replacement issues.
This article will go over if weightlifting is safe after shoulder replacement surgery, how long before weightlifting can begin again post-surgery, tips for weight lifting after a total shoulder replacement surgery, and what to avoid doing while recovering from your surgery.
Returning to Weightlifting After a Total Shoulder Replacement
Being able to return to weightlifting is a reasonable goal for anyone who has a total shoulder replacement. The biggest issue is ensuring that your shoulder has had adequate time to heal and is ready to return to weight training regularly.
Weight training can even be beneficial and help the replacement heal more and be more stable after the surgery. What is essential to know is that you will have to start with light weights, give your shoulder more days between workouts, and make sure that you don’t start too soon after surgery.
Strength training has been shown to help improve local blood flow, improve muscle strength and muscle health, and decrease pain levels associated with surgery. It’s a recommended part of any long-term plan to continue with shoulder health.
Is Strength Training Safe After a Shoulder Replacement
Yes, strength training is safe after a shoulder replacement. You’ll start resistance training in Physical Therapy with light weights, but this typically doesn’t happen until after 8-10 weeks from the date of surgery. At this point, lightweights are safe to use to strengthen the shoulder’s deltoid, rotator cuff, and other surrounding muscles.
The progress of strength training is slow initially after surgery. We typically progress at 10% to 15% each week after that to prevent causing any undue irritation or injury to muscles, tendons, or prostheses.
The sets and reps are also limited to prevent causing damage. You’ll want to start with a high repetition and low weight program. This may be 15 repetitions or more and will likely start at only 2-3 sets. This program will initially help improve stability and endurance in the shoulder muscles while keeping the risk for injury. You’ll be able to change to a hypertrophic program later in the recovery process, typically after 6 months from surgery.
When Can you Return to Weight Lifting After a Shoulder Replacement?
You’ll be able to begin a gym-based weight lifting program 12 weeks after a total shoulder replacement in most instances. At this time, you will be educated and directed under the guidance of a physical therapist. You’ll start with lightweights and high repetitions and start at 2-3x a week to allow for a full recovery between sessions.
You can typically start a more traditional weight lifting program at the 6 months after surgery time. At this point, the bones in the shoulder, tendon, ligaments, and muscles have had adequate time to recover. You’ve been using the shoulder and building up strength gradually, which reduces the risk of injury. You can start to reduce the repetitions and increase the amount of weight to cause muscle growth in size, also known as hypertrophy.
Pro Tip: You typically have a follow visit with the surgeon 6 months post-op. This is a great visit to get clearance to return to weight lifting.
Bench Press After a Total Shoulder Replacement
The bench press is a great exercise to work the chest and anterior shoulders; however, it should not be performed with the barbell until after that 6-month mark. You can start a chest press with lightweight dumbbells at 1-3 pounds beginning around 10-12 weeks after surgery.
Once you hit 6 months post-surgery, you can start to work towards bench pressing with the barbell. Test your strength first, as you should be able to use 15-20 pound dumbbells in a press exercise or perform a full push-up before you attempt to do a regular bench press. Remember, you will need to start at a much lighter weight than what you were doing before surgery.
Push-Ups After a Total Shoulder Replacement
You can start doing push-ups earlier in the recovery after a shoulder replacement. Once you get cleared for strengthening exercises, you will begin modified push-ups at the 10-12 weeks after surgery.
We recommend starting with wall push-ups first. This is a safe way to begin to build back strength without overdoing it on the shoulder. Try to get 10 wall push-ups with equal weight-bearing in each arm before you progress to more challenging exercises.
Once you get to 3-4 months after surgery, you can move to a modified push-up on a table, bed, or countertop. Walk your feet back until your body is angled near 45 degrees. Keep your elbows at a 45-degree angle as well. Don’t let the arms get way out to the side. You should be able to do 20 push-ups with equal weight-bearing before you progress to the next level.
At 5-6 months, you can move to push-ups from your knees on the floor. In this instance, you might start with fewer reps and go for sets of 5-6 until your shoulder feels more comfortable.
Finally, after working through the weakness, pain, and swelling, at 6-7 months, you can start practice and push your full plank push-up routine. Once again, try to progress at 10-15% per week to avoid injury.
Overhead Lifting After a Total Shoulder Replacement
One activity that often gets discouraged after a shoulder replacement and other shoulder surgery is lifting overhead. Lifting overhead is not something that we should avoid because sometimes life happens overhead. If we avoid reaching overhead post-surgery, then we might not be able to do what we need when the time comes.
Instead, it’s best to train safe and smart with resistance in overhead positions so that you can reach overhead with confidence and strength. We recommend starting by during wall slides with small weights of 2-3 pounds. You can start this around 12 weeks after surgery in most cases but be sure to check with the surgeon that you are cleared for strength training.
You want to increase the resistance for heavy weight lifting overhead as you work toward 6 months progressively. Keep the repetitions high and the weight low for this exercise.
Pro Tip: Be cautious not to progress the resistance too quickly for this exercise. You do not want to injure the rotator cuff by lifting too heavy too soon.
Risks of Weight Lifting After a Shoulder Replacement
There are a few risks for weight lifting after shoulder replacement surgery. The most significant risks include injuring the shoulder and rotator cuff, causing tendonitis, and irritating surrounding joints with compensations. When you lift weights, use common sense and be smart about what you can do with your new joint to prevent overdoing it too soon.
Injuring the Rotator Cuff After a Shoulder Replacement
The rotator cuff stays intact after a total shoulder replacement, so it is still at risk for injury as you’re recovering from surgery. You may have prior tears or injuries to the rotator cuff that existed before surgery, and now that you are starting to lift weights again, it can cause serious issues and even tears.
Be cautious with lifting overhead, with your arms straight out to the front or side, and lifting too early after surgery.
Causing Tendonitis and Other Overuse Injuries
Another risk is that if weight lifting is done too soon after surgery, it can lead to Rotator Cuff and shoulder tendonitis. Tendonitis and other overuse injuries, including Bursitis, can be a common occurrence after shoulder surgery. You’ll be doing your physical therapy exercises, beginning your own activities, and the shoulder just isn’t healed all the way yet.
You want your new shoulder joint healthy and strong before putting too much stress on it with weight lifting too frequently. Go slow only a few times per week and start with light weights and stay with this method for longer than you think you should.
Causing Other Joint Pain Through Compensations
Weight lifting after a shoulder replacement surgery needs a focus on proper form and resistance levels so that you don’t injure yourself by performing exercises you once enjoyed before your injury or surgery.
If you return to the resistance you were doing before surgery, you may not have the strength and cause your body to compensate in joints. Common compensations include muscles that attach to the neck, low back, and the other shoulder. A new onset of neck pain after a shoulder replacement is common and something we address in this post.
Remember that weight lifting after shoulder replacement surgery is very different than before the injury or surgery. With your doctor’s approval, be sure to start slow and follow all safety protocols so you can get back into weightlifting safely without re-injuring yourself again!
Pro Tip: Weight Lifting After a Shoulder Replacement is slow and takes time to build back up.
Weight Lifting Restrictions and Considerations After a Reverse Shoulder Replacement
A reverse total shoulder replacement is a different surgery and has various limitations after surgery. There is no longer a working rotator cuff muscle group in this surgery, and the deltoid muscle takes over to complete all of the movement. This surgery aims to reduce pain and maintain as much function as you can, not necessarily preserving strength.
We typically do not recommend returning to recreational weight lifting beyond what your physical therapist has prescribed for this surgery. Continue your strengthening and stretching exercises given to you, but we tend to stay away from heavy lifting, especially overhead.
We recommend no lifting greater than 25 pounds or repetitive lifting overhead after a reverse total shoulder replacement.
Tips for Returning to Weight Lifting After Shoulder Replacement Surgery
In order to get back to resistance training and weight lifting after a shoulder replacement surgery, there are a few tips that we recommend to patients. These are to help avoid a severe injury and to promote overall strength. These include
- Start slow and progress slow
- Use less resistance than you think you should
- Give yourself more rest days in between
- Don’t push through discomfort
- Start with machines first and progress to free weights
Conclusion
Weight lifting after shoulder replacement surgery is a slow process and should be done with caution. You will eventually return to weightlifting but start slowly, lift lighter weight than you think you should, and take more rest days in between. If something does not feel right or causes pain, back off and don’t push through.
Consult with a physical therapist to understand your limitations and safety needs for your specific shoulder. However, returning to weight lifting is something that is possible and helpful in long-term shoulder health.
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Disclaimer: The information provided in this post is for educational purposes only. This is not a substitute for a medical appointment. Please refer to your physician before starting any exercise program.
