“I am leaning towards the shoulder replacement because I do not know what else to do.”
We see shoulder pain patients, and no matter how unique their story is, most have the same common problems and the same common medical history. They tell stories like this:
The last treatment available – shoulder replacement
I have had shoulder pain for a long time; my line of work is physically demanding. I have been to my doctors and specialists many times. I have been given varying doses of different pain medications, muscle relaxants, and anti-inflammatories. I have had cortisone twice. I have been sent to physical therapy, tried chiropractic, and various electro-stimulation products. I am at the point now that my visits to the orthopedics are long discussions about surgical options.
I am here to explore other options. I do have a good range of motion in my shoulder, though I cannot lift my arm over my head because of weakness. I can pick up objects and carry them, I just can’t leave them on a table or platform above my waist.
The outcomes of patients being able to return to work following a shoulder replacement
A September 2022 paper in the World Journal of Orthopedics (1) assessed the outcomes of patients being able to return to work following a shoulder replacement. The researchers here made similar observations to those we see in patients. The patients looking into getting a shoulder replacement are younger and are prioritizing the need for the surgery as a means to get themselves back to work. Outcomes for return to work were measured in patients who had total shoulder replacement, reverse total shoulder replacement, and shoulder hemiarthroplasty.
Results: The majority of patients undergoing total shoulder replacement, reverse total shoulder replacement, or shoulder hemiarthroplasty were able to return to work between one to four months, depending on work (the extent of the physical demand of the job).
While sedentary or light-demand jobs generally have higher rates of return to work, moderate or heavy-demand jobs tend to have poorer rates of return. The rates of return to work following total shoulder replacement (71%-93%) were consistently higher than those reported for shoulder hemiarthroplasty (69%-82%) and reverse total shoulder replacement (56%-65%).
No clear consensus on returning to activity or sport after reverse shoulder replacement
A July 2019 study published in the journal Shoulder & Elbow (2) states clearly that “Reverse total shoulder arthroplasty is now the most frequently performed form of shoulder replacement. There is currently no consensus on recommended levels of activity and sport following Reverse total shoulder arthroplasty.”
However, these researchers do suggest that “Return to sport is tolerated following Reverse total shoulder arthroplasty; however, studies are short to medium term only and although the reported complication rate is low, the studies did not include a radiographic evaluation. Longer-term studies with subgroup analysis evaluating common recreational activities after reverse total shoulder arthroplasty are required, particularly in the younger population, in order to establish clear post-operative guidelines.”
A June 2025 study in the Journal of Shoulder and Elbow Surgery (3) found anatomical shoulder replacement patients have a 40% chance of perceiving their shoulder as normal. Among shoulder replacement patients who perceive their shoulder as normal, anatomical shoulder replacement patients outperform reverse shoulder replacement patients with better motion and greater ability to return to work, return to sport, and perform higher demand activities without difficulty.
70% return to sports – overhead sports remain problematic
A June 2021 study in the Orthopaedic journal of sports medicine (4) led by the Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota offers this opinion: “Patients who had undergone primary uni (one-sided)- or bilateral (both-sided) reverse shoulder replacement reported a 70.1% rate of return to sports with the maintenance of the same level of intensity, duration, and frequency of preoperative sport participation. Rates of return to high-demand sports were lower than low- and medium-demand sports. Patients also had difficulty returning to overhead sports.”
In this report, none of the patients returned to these “high-demand sports”:
- Badminton
- Basketball
- Racquetball/handball
- Tennis
- Volleyball
More articles
References
1 Lalehzarian SP, Agarwalla A, Liu JN. Return to work following shoulder arthroplasty: A systematic review. World Journal of Orthopedics. 2022 Sep 18;13(9):837-52. [Google Scholar]
2 MacInnes SJ, Mackie KE, Titchener A, Gibbons R, Wang AW. Activity following reverse total shoulder arthroplasty: What should surgeons be advising?. Shoulder & elbow. 2019 Jul;11(2_suppl):4-15. [Google Scholar]
3 Beleckas CM, Schodlbauer DF, Mousad AD, Levy JC. Evaluation of new normal after shoulder arthroplasty: comparison of anatomic vs. reverse total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery. 2025 Jun 1;34(6):S43-9. [Google Scholar]
4 Tangtiphaiboontana J, Mara KC, Jensen AR, Camp CL, Morrey ME, Sanchez-Sotelo J. Return to Sports After Primary Reverse Shoulder Arthroplasty: Outcomes at Mean 4-Year Follow-up. Orthopaedic Journal of Sports Medicine. 2021 Jun 10;9(6):23259671211012393. [Google Scholar]