Total shoulder replacement: managing daily activities

This information will help you learn how to safely complete your daily living and mobility tasks, following your total shoulder replacement. It includes advice on how to pace yourself, and plan and prioritise everyday tasks.

It is occupational therapy guidance and does not replace advice given to you by your medical team.

Preparing for surgery

When you know the date of your surgery, you can start planning for your recovery afterwards. For example you can think about how you will carry out daily practical tasks that will be difficult to complete with one hand.

For useful suggestions, see our leaflet on 'Managing tasks at home using one hand'.

Recovery after surgery

After surgery, your arm movement will be limited and this will affect the way you manage everyday tasks. They may take longer to complete than usual, or be painful and more tiring. You may need help from a family member or carer, especially to help you wash and dress.

The hospital team can discuss with you the available options for assistance with daily living tasks, if needed.

Remember that everyone recovers at their own speed and not all strategies work for everyone.  We advise you to practise the strategies below before you have surgery, if possible. This will help you find out which ones work best for you.

To see more practical advice, visit the Royal College of Occupational Therapists website and view their booklet on managing energy levels.

Washing and dressing

It is important that you are able to remove and reapply your sling, to undertake washing and dressing tasks. The nursing staff or therapy team will show you how to do this safely.

You may need assistance from a family member or carer, to help you take your sling off and put it on again. 

What to expect

You will likely experience some pain and limited range of movement in your shoulder after surgery.

You may find it difficult to perform some tasks which are part of washing and dressing. These include:

• reaching behind your back or above your head
• getting in and out of the bath if you typically rely on both arms for weight-bearing
• holding and opening bottles, tubes, and tubs.

You may also find it hard to maintain your balance. This is because wearing a sling restricts the natural arm movements that help to maintain balance. This increases the potential risk of falling.

Tips to help you wash 

During the first week after surgery you need to keep the wound dry, which means you must not get the dressing wet while washing.

• During the first week, when washing, use a waterproof dressing to protect your wound and keep it dry. We can advise you on the most appropriate dressings to use.
• Long-handled aids can help you reach behind your back or down to your feet. You can buy these low-cost items online or at mobility shops.  
• When washing your armpits, use your unaffected arm to reach up and clean the affected armpit.  
• If you experience tiredness or balance issues, consider using equipment, or having a strip wash while you are sitting.     
• To make washing easier, try using a sponge and liquid soap or shower gel. It is easier to squeeze the water out of a sponge.  
• After washing, try wrapping yourself in a towelling bathrobe to dry yourself with minimal effort.  

Tips to help you dress

• Try sitting down while dressing to maintain your balance and conserve your energy.
• Choose easy-to-manage clothing to simplify dressing. Avoid slippery, silky or tight items. Opt for clothes with Velcro or elastic fastenings or slip-on style clothing without fastenings instead of buttons and zips. For bras, use front-fastening styles or secure back-fastening bras at the front before twisting them into place. 
• Consider slip-on shoes or those with Velcro or elastic laces to make footwear easier to manage.
• When putting on clothes, dress your affected arm first and undress it last.
• Use your unaffected arm to stabilise clothing, hold items in place and carry out the main movements of dressing.
• When putting on socks, open them wide between the thumb and index finger of your unaffected hand, then slide them over your foot. 
• Dressing aids can be helpful. These include dressing sticks, button hooks, shoehorns, and bra angels. You can buy these low-cost items online or at mobility shops. 

Toileting

What to expect 

After your surgery, you will need to wear a sling for up to 6 weeks. During this time, you will be unable to fully weight-bear through your affected arm. 

You may find it hard to sit down and stand up from the toilet. This is because toilets are usually low in height, and you will not be able to use both arms for support and balance. The extra time you need can increase the risk of incontinence.

Wiping yourself and adjusting your clothing may also be difficult, as you will need to manage with one hand.

You may need an occupational therapy assessment for adaptive equipment such as a raised toilet seat, to assist with sitting and standing. 

Tips to help with toileting

• Before surgery, try practicing one-handed techniques (using your unaffected arm) to complete toileting and personal care tasks.
• Allow plenty of time to go to the toilet, as it may take longer than usual.  
• Place hygiene items you are likely to need within easy reach of your unaffected arm.
• Position toilet paper on the side of your unaffected arm and tear off sections in advance.  
• A bottom wiper can be helpful if you have limited reach or need to use your non-dominant hand. You can buy one online or from mobility shops.
• If available, use secure rails around the toilet to push up when using one hand.
• If available, a bidet can assist with washing and drying after using the toilet.

Getting in and out of bed

What to expect

After surgery, you will be unable to weight-bear through the affected arm. This will affect your ability to do the following:

• maintain sitting balance
• stabilise yourself when lifting your legs into bed
• push up from lying to sitting
• reposition in bed
• get comfortable in bed, as you will not be able to sleep on the affected side.

You may need an occupational therapy assessment for adaptive equipment to help you with bed transfers and positioning.   

Tip for getting in and out of bed

• Before your surgery, practice getting into bed to find out which side is easiest for you. You may find it easier to get out of bed on the side of your unaffected arm. 

Meal preparation

What to expect

As you will be required to wear a sling and be unable to fully weight-bear through the affected arm for up to 6 weeks, preparing daily meals may take longer than usual. You may find it difficult to:

• open food packaging and containers
• peel and cut up food  
• move the items you need around the kitchen and take your meals to the table or chair where you eat
• move saucepans, frying pans, trays and other cooking equipment. You will need to be extra careful and possibly learn some one-handed techniques.  

Tips for meal preparation

Before your surgery, we advise you to do the following:

• Stock up your cupboards and freezer. Consider batch cooking meals in advance.
• Think about reorganising your kitchen so that the things you use most are within easy reach.
• Transfer loose foodstuffs to easy-to-open containers.
• Practice kitchen tasks using your unaffected arm.

After your surgery, follow the guidance below.

• Allow plenty of time to complete each task. Break the task down into manageable steps, and take breaks when you need them.  
• Have a chair or stool available to use when you are preparing food, or rest on.
• Try and cook simple meals. Consider using ready meals instead. Avoid foods that need lots of cutting and chopping. Think about using sliced bread and pre-chopped or frozen vegetables. 
• Push items along surfaces instead of picking them up and carrying them. 
• Place saucepans at the back of the hob to avoid the risk of knocking them over. 
• Use a slotted spoon or a wire mesh cooking basket to drain foods from boiling water. This will avoid the need to carry hot saucepans with one hand. Wait until cooking water is cold before you empty it from the saucepan.  
• Kitchen aids such as a chopper, one-handed can opener, spike board, and rocker knife can be useful. You can buy them online or at mobility shops.