Phase 4 · Recovery · Phase 5 · Lifestyle Design

Recovery ends when you are back to the life you had the surgery for — not when the imaging looks acceptable.

A week-by-week recovery pathway with named milestones, named contacts, and a written protocol for every procedure. Honest about difficulty. Specific about timeline. Measured in Monday mornings.

Phase 4 · Recovery.

Phase 4 has named milestones at week 1, week 6, three months, six months and twelve months. At every milestone there is a defined review with Dr Coory; between milestones, your physiotherapist sees you weekly and your care coordinator is the named contact in the rooms.

The first 48 hours after major shoulder surgery are typically the most physically demanding. We tell patients this because knowing it in advance makes it manageable — not because knowing it in advance makes it easier.

Preparation (the week before surgery).

Pre-admission clinic — anaesthetic review, medication review, fasting instructions.
Cessation of anti-inflammatories and blood thinners as advised in your written plan.
Arrange a driver for the day of surgery and the days following.
Set up the bedroom: a recliner or extra pillows for the first 2–4 weeks of shoulder recovery.
Confirm your physiotherapy provider before surgery. Your treating physiotherapist will receive the procedure-specific written rehabilitation protocol on the day of surgery.

Day of surgery.

Arrive at the hospital two hours before the scheduled time.
Anaesthetist places a regional block in addition to general anaesthesia for shoulder surgery — this gives 12–18 hours of post-op pain control.
Recovery in the post-anaesthetic care unit for one to two hours.
Discharge home the same day (arthroscopy, carpal tunnel) or to the ward for inpatient stay (shoulder replacement).

Week 1 — the first milestone.

The regional block wears off in the first 12–24 hours; expect a peak in pain on days 2–3.
Take analgesia regularly during this window, not just on demand. Your written plan specifies the regimen.
Wound dressing kept dry until your scheduled review.
Begin the prescribed range-of-motion exercises with your physiotherapist.
Sleep upright or semi-reclined for the first 1–2 weeks of shoulder recovery.
Defined review: with Dr Coory at week 1 (in person or telehealth).

Weeks 2–6.

Sling timing depends on the operation: 1 week for reverse and robotic shoulder replacement (accelerated protocol); 4–6 weeks for rotator cuff repair and anatomic shoulder replacement (cuff protection).
Active-assisted range of motion begins immediately after the sling is discontinued, under your physiotherapist.
Light activities with the non-operated hand — typing, eating, dressing.
Physiotherapy once or twice per week.
Most patients return to a desk job between weeks 1–3 (earlier after reverse/robotic; slightly later after anatomic or cuff repair).
Driving generally resumes at approximately 2 weeks after reverse/robotic shoulder replacement, and at 6 weeks after anatomic shoulder replacement or rotator cuff repair, once off opioid analgesia. Hand/elbow procedures: 1–2 weeks.

Week 6 — the milestone that shifts the pathway.

For anatomic shoulder replacement and rotator cuff repair, the sling is discontinued at this point.
Strengthening commences for the reverse and robotic shoulder replacement patients (who have been out of the sling for several weeks already).
Active range-of-motion exercises progress across all shoulder operations.
Light manual work resumed in this window for most procedures.
Defined review: with Dr Coory at six weeks. The plan for the next phase is written down at this review.

Months 3–6.

Strengthening commences in earnest. Posterior cuff and scapular stabilisers first; deltoid and pectoralis second.
Return to most manual work and recreational activity.
Return to non-contact sport.
Defined review: with Dr Coory at three months and six months.

Months 6–12 — entering Phase 5.

Return to contact sport and heavy overhead work where appropriate.
Strength continues to improve out to 12 months.
Defined final review: with Dr Coory at 12 months.

Phase 5 · Lifestyle Design.

The 12-month review is not really a clinical check. The radiograph confirms the implant or the repair has done its mechanical work. The conversation that matters is the one after the X-ray is reviewed: what can you do on a Monday morning that you could not do before?

That is the test that decides whether the operation worked. Not the imaging. Not the range-of-motion measurement. The Monday morning — the named, specific, physical thing the shoulder was supposed to make possible again.

The Monday mornings my patients have brought back to clinic, in their own words: lifting a baby out of the cot with two hands; driving from Toowoomba and back without a break; serving the first ball of a club doubles match; reaching the top kitchen shelf without thinking which arm; sleeping on the operated side; painting a bedroom ceiling.

That is the standard. That is what we are working toward.

Procedure-specific written protocols.

Phase 4 has a written rehabilitation protocol for each procedure. Your treating physiotherapist receives the specific protocol on the day of surgery. The protocols are also available to you on the relevant procedure page:

Physiotherapists can also request protocols directly via email. One email, one business day.