Preparing for shoulder surgery

Preparing for shoulder surgery

As our nation’s healthcare resources are directed to handle the Coronavirus crisis, the result has meant a complete suspension of all private, elective surgery following the agreement formed last month between the NHS and the independent sector to reallocate the latter’s hospital capacity to NHS use.

The NHS has also understandably now cancelled all routine operations for the next three months, leaving many patients in limbo waiting to undergo much-needed surgery. However, even though there is now some uncertainty over when your shoulder operation may take place, it’s never too early to start ‘PreHabing’ before your operation.

PreHab encompasses all the same aspects of your post-surgery rehabilitation programme, touching on elements of nutrition, exercise and pain management, but you should embark on PreHab in advance of your surgery to ensure optimal recovery and the ultimate success of your procedure.

Ideally, you should have at least a few months pre-procedure to get in the best possible health. Some lifestyle factors that increase your surgical risk, such as smoking or being overweight, should be addressed as early as possible for you to experience the benefits.

1. Lose weight

The impact of carrying extra weight on your hip and knee joint is self-evident, but it can also cause shoulder pain, with normal range of motion diminished by nearly 40%, causing increased wear and tear.

A recent study also found that the higher the patient’s BMI, the more chance of post-surgical complications, including the need for revision surgery.

2. Quit smoking

 Stopping smoking in advance of rotator cuff tear or labral repair is probably one of the most important things you can do to improve your chances of surgical success – in fact, some believe that smoking may be the most important factor in your risk of developing complications after shoulder surgery, which can include infection, poor wound healing or less than satisfactory results.

This is supported by a number of studies, including a 2018 report into smoking and arthroscopic rotator cuff repair, published in the British Medical Journal Open Sport & Exercise Medicine, that found that although smokers will still benefit from surgery, they tend to present with larger tears and had a worse initial outcome and a lower functional improvement after surgery.

3. Address health concerns

 Not all shoulder surgery patients present with a secondary health condition, but diabetes can increase your risk of tendon damage, particularly rotator cuff tears. Tendon damage in type 1 and type 2 diabetes is the result of an accelerated production of advanced glycation end products (AGEs) that affect the structure of tendons and how they perform. Raised blood sugar levels can also affect your healing post-procedure, so addressing your diet during your PreHab can help you keep your blood sugar levels down.

 4. Start moving

 Although PreHab encompasses diet and other lifestyle factors, exercise is probably one of the most important aspects. Before any joint procedure, including shoulder surgery, improving the strength, flexibility and range of motion in the muscles that support the joint is essential. A quicker healing process post-procedure can be the direct result of the work you put in beforehand.

For more advice on how best to prepare for shoulder surgery, call us on 020 3195 2442 or email Although all non-urgent / elective surgery bookings and appointments are postponed at the moment, the London Shoulder Specialists are still available for consultation either by telephone or video link.