Advice for Post-Surgical Recovery from Shoulder Replacement

Question: I am going to schedule a left-shoulder replacement soon and would like to know if recovery will be more difficult with atrophied left paraspinal muscles. I had polio at eight years of age and was paralyzed from my neck down. I made a remarkable recovery and am now 77 years old. I have never needed mobility aids, but I do have PPS, especially in my core area. Any tips you might have regarding physical therapy precautions or other insights which would aid my post-surgical recovery would be much appreciated.

Answer from Frederick Maynard, MD: If you have visible atrophy of your left paraspinal muscles in the upper chest or neck areas, weakness of your scapular stabilizing muscles may complicate your recovery from shoulder arthroplasty. I would recommend pre-op assessments by a Physical Medicine & Rehabilitation (PM&R) physician and a physical therapist that can be involved with your post-op rehabilitation planning in conjunction with the orthopedic surgeon who does the procedure. It will be important to avoid overuse of any polio-involved muscles during post-op exercises.

If your overall postural and leg strength is sufficient for you to not need upper extremity devices (e.g., canes, crutches, walkers) for walking, then you should be a good candidate for shoulder arthroplasty to relieve significant pain and/or reduced range of motion. Shoulder arthroplasty (especially “reverse shoulder arthroplasty”) can result in some decrease in the maximum strength of some shoulder movements, but this is not significant for those who have no regular need for routine high strength of shoulders, as in lifting oneself for transfers or walking with devices, or if previous polio did not significantly affect the shoulder muscles. Your PM&R physician can also consider doing electrodiagnostic testing, as they think necessary, for assessing your shoulder muscles for degree of old polio involvement.

Post-Polio Health (Vol. 41, No. 1, Winter 2025)