[6 MIN READ]
In this article:
-
The shoulder is one of the most flexible, hardworking and vulnerable joints in the body.
-
When arthritis or tendon damage causes pain or loss of movement, shoulder replacement can restore function and comfort.
-
A Providence Swedish orthopedic surgeon explains how modern shoulder replacement works, what recovery looks like and what patients can expect.
How shoulder joints work and why they matter
Your shoulders carry a lot of responsibility, literally. These powerful ball-and-socket joints give your arms the strength and flexibility to lift, reach, throw and write — all the movements that keep your life in motion.
“The shoulder is unique because it handles both fine and gross motor movements,” explains Daniel Schwartz, M.D., a shoulder and elbow orthopedic surgeon at Providence Swedish Orthopedics. “While our hips mainly keep us upright and walking, the shoulders allow us to move our hands anywhere in space.”
Fine motor movements are the small, precise actions that require careful control, like writing, buttoning a shirt or reaching for your phone. Gross motor movements are the larger, strength-based motions, such as lifting a box or swinging a tennis racket. The shoulder handles both, which is what makes it so useful — and so vulnerable.
Dr. Schwartz shares more about how this remarkable joint works, why it can wear down over time and how shoulder replacement surgery can help you get back to the activities you love.
Why shoulder joints wear down
Like any joint in the body, the shoulder can change with age and use. Years of movement and activity can gradually wear down the smooth cartilage that cushions your shoulder bones. As that protective layer thins, the bones begin to rub against each other, causing arthritis.
“Arthritis is the most common reason people need a joint replacement,” says Dr. Schwartz. “Cartilage acts like a frictionless surface between the bones. When it breaks down, you lose that smooth movement, and the joint becomes painful and stiff.”
Tendon damage can also be a factor. The shoulder relies on the rotator cuff, a group of muscles and tendons that keep the joint stable and moving smoothly. When one or more of these tendons tears, it can seriously affect how the shoulder works.
“Because the shoulder performs so many fine movements, a bad rotator cuff tear can make everyday tasks difficult,” Dr. Schwartz explains. “In these cases, patients may need a shoulder replacement even without arthritis.”
Shoulder pain and stiffness are worth paying attention to. If they start to interfere with daily activities, such as dressing, reaching overhead or sleeping comfortably, it may be time to talk to your doctor.
Different types of shoulder replacements
There isn’t just one kind of shoulder replacement. Your surgeon tailors the procedure to your anatomy, activity level and the extent of joint damage.
“It really comes down to whether we can restore the shoulder’s natural anatomy or if we need to change it completely,” Dr. Schwartz explains.
In an anatomic total shoulder replacement, the surgeon restores the joint’s original ball-and-socket structure using metal and plastic components. This option is often best for patients whose bone structure and rotator cuff are still intact.
When only one side of the joint is damaged, a hemiarthroplasty may be the right choice. This procedure replaces only the ball of the shoulder, called the humeral head. For active patients, surgeons may use alternative materials, such as pyrocarbon, to reduce wear over time.
A reverse shoulder replacement, on the other hand, switches the position of the ball and socket. This design allows other muscles, rather than the damaged rotator cuff, to lift and move the arm. It’s typically used when the rotator cuff is torn beyond repair or when arthritis and tendon damage occur together.
“There’s a lot of nuance in choosing the right replacement technique,” says Dr. Schwartz. “Each has its pros and cons, and I walk through those details with every patient so they know what to expect.”
What happens during shoulder replacement surgery?
Before your procedure begins, you’ll receive anesthesia to stay comfortable and pain-free. Once you’re ready, the surgeon makes a small incision at the front of your shoulder. They carefully move the muscles aside to reach the joint.
“The first step is to remove the damaged bone and cartilage,” says Dr. Schwartz. “Then we reshape the surfaces and resurface the ball and socket with new materials that fit the patient’s anatomy.”
Depending on what your shoulder needs, your surgeon may replace the ball with a smooth metal piece and the socket with a durable plastic liner. This way, your joint can glide smoothly again.
“It’s a very methodical procedure,” says Dr. Schwartz. “We take our time to make sure everything fits correctly, and then we repair the soft tissues before closing the incision.”
The entire operation typically takes between one and two hours. Most patients can start gentle movement soon after surgery with help from their care team. As with any surgery, there’s a small risk of infection — about 1% — but shoulder replacement is generally safe and well-tolerated.
Life after shoulder replacement
Healing looks a little different for everyone. Dr. Schwartz notes that shoulder replacement recovery can take anywhere from three months to a year, depending on your activity level and goals.
“Some people regain basic function within a few weeks. They may be able to feed themselves and complete simple tasks comfortably,” he says. “Others may need six months or more before they’re back to doing everything they enjoy.”
In the first few weeks after surgery, you’ll wear a sling to protect your shoulder and help the area heal. Many patients can start gentle exercises within the first month, focusing on small, comfortable movements. As strength and range of motion improve, you can gradually return to driving, light housework, deskwork and other daily activities.
Physical therapy can help with recovery, but it isn’t required for everyone. Dr. Schwartz emphasizes that the most important step early on is patience. Give your shoulder tissues time to heal before pushing too hard.
“I tell patients that their shoulder may not be back to 100% for a while, and that’s okay,” he says. “Full recovery — the point when your shoulder feels natural and strong again — can take up to a year.”
For Dr. Schwartz, the ultimate goal for his patients is freedom, including freedom from pain and freedom to move. While some surgeons place strict long-term limits on lifting or overhead work, he takes a more flexible approach.
“I just want patients to enjoy their new shoulder,” he says. “If they wear it out after 15 or 20 years, I’ll be here to help them again. I’d rather see them living their lives than being afraid to move.”
Learn more and find a physician or advanced practice clinician (APC)
If shoulder pain is affecting your daily life, the Swedish Orthopedic Institute can help. Our experts perform hundreds of replacement surgeries every year and bring extensive experience with a wide range of techniques and complex cases.
You can also schedule a virtual consultation through Swedish ExpressCare Virtual. Use our provider directory to connect with an orthopedic surgeon or primary care physician near you.
Related resources
A new shoulder helped this athlete continue his decades-long winning streak
Get the facts on joint replacement
How do you know if it’s arthritis?
Keep moving! Maintain mobility as you age.
What you “kneed” to know about caring for your joints
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
Providence Swedish experts in the media
Follow us on Facebook, Instagram and X.
About the Author
More Content by Swedish Orthopedics & Sports Medicine Team
