When a shoulder is damaged by an injury causing dislocation, surgery may be required. The orthopedic surgeon will suture and repair the damaged tissue to restore the structural integrity of the joint and stabilize the shoulder.

Following surgery to stabilize the shoulder, your arm will be placed in a sling, usually for 4 to 6 weeks. During this time, you will not be allowed to use your arm for everyday activities.

Right after surgery, your shoulder will be painful and stiff, and it might swell. Your health care team will provide you with methods to control pain and swelling, such as icing and training on proper positioning.

Your physical therapist will guide you through your postsurgical rehabilitation. Your therapist will design a specialized treatment program based on your condition and goals. Treatments may range from gentle range-of-motion and strengthening exercises to activity- or sport-specific exercises. The timeline for your recovery will vary, depending on the surgical procedure and your general state of health, but a full return to sports, heavy lifting, and other strenuous activities might not begin until 4 to 6 months after surgery.

CAUTION: Your shoulder will be very susceptible to reinjury. It is extremely important to follow the postoperative instructions provided by your surgeon and physical therapist.

Physical therapy after your shoulder surgery is essential to restore your shoulder’s function. Your rehabilitation typically will be divided into 4 phases:

• Phase I (maximal protection). This phase lasts for the first few weeks after your surgery, when your shoulder is at the greatest risk of reinjury. Your arm will be placed in a sling, and you likely will need assistance or special strategies to accomplish everyday tasks, such as bathing and dressing.
  
  Your physical therapist will teach you gentle range-of-motion and very light strengthening exercises using only the weight of your arm.Your therapist may provide hands-on techniques, such as gentle massage, to help ease any pain, swelling, and stiffness, and will offer advice on how you can reduce your pain. Cold compression or electrical stimulation also may be applied for pain relief. Some of the treatments begun in this phase may continue as needed, until approximately the 12-week mark.
• Phase II (moderate protection). This phase typically begins about 1 month following surgery, with the goal of restoring mobility to the shoulder. You will reduce the use of your sling, and your range-of-motion and strengthening exercises will progressively become more challenging throughout this period. In the early parts of this phase, strengthening will not include extra resistance; that will be included at a later point in your rehabilitation.
  
  Your physical therapist will add exercises to strengthen the "core" muscles of your trunk and shoulder blade (scapula), and your "rotator cuff" muscles—the ones that provide additional support and stability to your shoulder. You will be able to begin using your arm for daily activities, but you'll still avoid any heavy lifting with your arm both during physical therapy and at home. Your physical therapist may use special joint mobilization techniques during this phase to help restore your shoulder's range of motion. With clearance from your surgeon, you may begin light cardiovascular activities, such as riding a stationary bike or walking on a treadmill.
• Phase III (return to activity). This phase will typically begin about 3 months after surgery, with the goal of restoring your strength and joint awareness to equal that of your other shoulder. At this point, you should have full use of your arm for daily activities, but you will still be unable to participate in activities such as sports, yard work, or physically strenuous work-related tasks. Your physical therapist will increase the difficulty of your exercises as you progress. You might be able to start a modified weight-lifting or gym-based program during this phase.
• Phase IV (return to occupation/sport). This phase will typically begin about 4 months after surgery with the goal of helping you return to sports, work, and other higher-level activities. Your physical therapist will instruct you in activity-specific exercises to meet your needs. For certain athletes, this may include throwing and catching drills. For others, it may include practice in lifting heavier items onto shelves or instruction in raking, shoveling, or housework. Your physical therapist also might recommend a shoulder brace to allow you to gradually and safely return to your regular activity level without reinjury.

Shoulder dislocation may be preventable. See your physical therapist if you:

• Have pain in your shoulder, especially when performing forceful activities, such as throwing a ball or lifting objects overhead
• Have symptoms that feel as though your shoulder is “slipping," “shifting,” or “moving”
• Hear a popping sound in your shoulder

Your physical therapist can guide you through strengthening exercises and special drills to improve the ability of your shoulder muscles to respond to forceful physical demands as needed. If you are at risk for shoulder dislocation, your physical therapist can show you positions to avoid to help prevent injury. The riskiest position is that of raising the arm overhead while it’s rotated outward, as happens with overhand throwing. Physical therapists help people modify their movements to avoid this position, or teach pitchers and other athletes strengthening exercises and correct body mechanics to lessen the chance of injury.

All physical therapists are prepared through education and experience to treat patients who have had surgery on a dislocated shoulder; however, you may want to consider:

• A physical therapist who is experienced in treating people with musculoskeletal problems. Some physical therapists have a practice with an orthopedic focus.
• A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedics or sports physical therapy, and has advanced knowledge, experience, and skills that may apply to your condition.

You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you're looking for a physical therapist (or any other health care provider):

• Get recommendations from family, friends, or other health care providers.
• When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people after shoulder surgery.
• During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.