Shoulder pain can make simple things—sleeping, reaching into a cabinet, lifting a child, or swinging a golf club—frustrating or even impossible. If you live in Omaha, Elkhorn, Gretna, Bennington, Waterloo, Fremont, or Council Bluffs and have been told you have shoulder arthritis, a massive rotator cuff tear, or bone-on-bone wear, shoulder replacement surgery may finally restore your comfort and motion.
As a fellowship-trained Shoulder & Elbow Surgeon at MD West ONE and Methodist Hospital in Omaha, I perform both anatomic and reverse shoulder replacements, matching the implant and technique to your shoulder, goals, and timeline. This guide explains when shoulder replacement is needed, what surgery involves, and—most importantly—what recovery really looks like week by week.
Do I Need a Shoulder Replacement?
You may be a candidate if you have:
- Bone-on-bone arthritis (glenohumeral osteoarthritis or rheumatoid arthritis)
- Irreparable or massive rotator cuff tears with pain and loss of elevation
- Pain that disrupts sleep or limits daily tasks despite therapy and injections
- Progressive stiffness, grinding, or catching
- Imaging (X-ray/MRI) showing joint degeneration, cysts, osteophytes, or cuff tear arthropathy
If you’re unsure whether you’re at this point, schedule an evaluation so we can review your imaging, exam, and goals together
Anatomic vs Reverse Shoulder Replacement (The Short Version)
- Anatomic Total Shoulder Replacement (aTSA): Best when your rotator cuff is intact. It replaces the ball with metal and resurfaces the socket with high-density polyethylene, preserving native biomechanics and typically providing excellent rotation.
- Reverse Total Shoulder Replacement (rTSA): Best when the rotator cuff is torn or not functioning. The ball and socket are “reversed” so your deltoid muscle powers arm elevation. This design offers reliable pain relief and strength when the cuff can’t.
Where Is Surgery Performed?
I perform shoulder replacement at:
- Methodist Hospital (Omaha, NE) — Advanced ORs, excellent anesthesia and nursing teams, and shoulder-savvy inpatient care.
- Midwest Surgical Hospital — For carefully selected patients who qualify for outpatient shoulder replacement with safe same-day discharge.
Our teams coordinate closely with physical therapy partners across Omaha and Western Iowa so your recovery plan is seamless from day one.
What to Expect on the Day of Surgery
- Anesthesia & Nerve Block: You’ll receive general anesthesia and a regional nerve block for targeted pain control. The block often provides significant pain relief for 12–18 hours after surgery.
- Length of Surgery: About 60 minutes depending on anatomy and any additional procedures (e.g., biceps work).
- Incision & Technique: A small anterior (front-of-shoulder) incision with careful soft-tissue handling to minimize swelling and stiffness risk.
- Going Home: Many patients go home the same day; others stay one night at Hospital depending on health status and support at home.
Recovery Timeline—Week by Week
Every shoulder is unique. Tear patterns, bone quality, pre-op stiffness, and overall health influence recovery. That said, most Omaha patients follow a similar arc:
Weeks 0–2: Protect, Control Pain, Gentle Motion
- Sling when out and about; remove for hygiene and therapy exercises and when in safe and protected environment
- Keep the incision clean and dry
- Hand, wrist, and elbow motion begins immediately
- Ice regularly; sleep in a recliner or propped on pillows
- Short, multimodal pain plan (acetaminophen, NSAIDs if safe, small amount of prescription medication as needed)
Goals: Pain control, swelling reduction, safe daily activities around the house.
Weeks 2–6: Active and Passive Range of Motion (PT-Guided)
- Start active and passive shoulder motion with a physical therapist
- Emphasis on forward elevation and external rotation without stressing the repair
- No lifting or pushing with the operative arm; keep activities below shoulder height
- Driving typically resumes once you’re off prescription pain medications and can safely control the vehicle
Goals: Prevent stiffness, protect healing tissues, establish smooth assisted motion.
Weeks 6–12: Active Motion & Early Strength
- Transition from passive to active-assisted, then active motion
- Begin light strengthening of deltoid and periscapular muscles
- Progress functional tasks (counter-level reaching, light housework)
- Many patients return to desk work well before this; light-duty roles often resume here
Goals: Restore control and endurance; build a foundation for everyday function.
Months 3–6: Build Strength & Return to Life
- Increased strengthening: rows, modified presses, rotator cuff and scapular work
- Golf: putting and chipping often by 8–12 weeks; fuller swings usually closer to the 4–6 month mark (with clearance)
- Pickleball, tennis, swimming, manual work: gradually phased in with therapist guidance
Goals: Confident lifting, overhead reach, and symptom-free sleep.
6+ Months: Peak Function
- Continued strength gains, better endurance, and more natural mechanics
- Most patients feel “this is my new shoulder” between 6–12 months
- Avoid extreme heavy powerlifting; respect the joint for longevity
Your exact timeline depends on whether you had anatomic or reverse, tissue quality, and your pre-op condition. We personalize your milestones at each visit (Contact our office to review your plan).
Pain Management & Sleep Tips
- Use the sling as directed early on; the support reduces muscle guarding.
- Ice after therapy and before bed.
- Sleep in a recliner or on your back with pillows to elevate the torso and support the operative arm.
- Aim for short walks daily—movement promotes circulation and reduces stiffness.
- Expect the first 7–10 days to be the most uncomfortable; the nerve block helps you through the early window.
Risks—and How We Reduce Them
All surgery carries risk. We minimize complications by matching the right procedure to the right shoulder, using meticulous technique, and guiding a smart rehab plan.
- Stiffness: Avoided with early, safe motion and adherence to PT.
- Infection: Uncommon; we use strict sterile technique and peri-operative antibiotics.
- Instability or dislocation (reverse): We protect positions early and educate you about safe ranges.
- Implant wear/loosening (long-term): We counsel you on activity choices that preserve the implant over decades.
- Blood clots: Low risk in shoulder surgery; we assess your health profile and use prevention when appropriate.
If you have diabetes, nicotine use, or prior surgeries, we’ll optimize those medical factors pre-operatively to set you up for success.
Sidebar: Anatomic vs Reverse Shoulder Replacement—Which One Do I Need?
| Feature | Anatomic Total Shoulder (aTSA) | Reverse Total Shoulder (rTSA) |
| Rotator Cuff Required? | Yes—cuff should be intact/functional | No—designed for deficient cuff |
| Best For | Primary osteoarthritis, arthritis with good cuff | Massive cuff tear, cuff tear arthropathy, complex fractures, some revisions |
| Primary Power Muscle | Rotator cuff + deltoid | Deltoid compensates for cuff |
| Motion Profile | Often better rotation (internal/external) | Often better elevation strength |
| Typical Age Range | Often younger/active but varies | Often older or those with failed prior repairs |
| Dislocation Precautions | Standard precautions | Early awareness of certain arm positions |
| Rehab Focus | Restore rotation and smooth mechanics | Train deltoid and scapular synergy |
| Longevity/Activity | Avoid heavy powerlifting/impact loads | Same—respect the joint for durability |
The “best” option is the one that fits your anatomy and goals. We’ll decide together after exam and imaging (Learn about our evaluation process).
What Results Can I Expect?
Most patients report:
- Substantial pain relief within weeks and continued gains for months
- Improved sleep (often one of the biggest wins)
- Confidence with overhead reach for daily tasks
- Return to golf, swimming, light tennis/pickleball, and active grandparenting
- The ability to carry groceries, lift light objects, and enjoy normal life again
Why Patients Choose Dr. Michael Del Core in Omaha
- Fellowship-trained shoulder surgeon focused on modern, minimally invasive techniques
- Affiliated with Methodist Hospital & MD West ONE—trusted teams, excellent outcomes, and coordinated rehab
- Clear communication: I explain the “why,” not just the “what,” and we set your recovery milestones together
- Local convenience across Omaha and Western Iowa with therapy partners close to home
- Personalized planning: Work, sport, and family goals drive your surgical and rehab strategy
If you’re comparing surgeons, ask about fellowship training, annual shoulder replacement volume, complication rates, and how outcomes are tracked—these are the markers of a high-quality shoulder program (See what to ask before surgery).
Frequently Asked Questions
How long will I be in a sling?
Usually 2–4 weeks adjusted to your tissue quality and comfort.
When can I drive?
When you’re off prescription pain meds and can safely control the vehicle—often after the early protection phase.
When can I return to work?
Desk/remote work: 1–2 weeks (sling on). Light duty: 4–8 weeks. Manual/overhead labor: 3–6+ months depending on job demands.
Can I golf again?
Yes. Putting/chipping as early as 8–12 weeks, progressing to fuller swings near 4–6 months with clearance.
How long will my implant last?
Modern implants are designed for long service life. Your activity choices and body factors influence longevity; we’ll discuss a plan that protects your shoulder for years.
Next Steps—Let’s Build Your Plan
You don’t have to live with shoulder pain. If you’re in Omaha or Western Iowa, we’ll help you decide whether anatomic or reverse shoulder replacement is right for you—and guide you through a recovery plan that fits your life.
- 402-390-4111 to request an appointment
- Michaeldelcoremd.com
