After a shoulder arthroscopy with subacromial decompression on its own, most people use a sling for comfort for a few days to 2 weeks and start moving the arm early. Desk work often returns within 1 to 3 weeks, driving often at 2 to 6 weeks, and overhead reaching gets easier over 6 to 12 weeks. Full recovery typically takes 3 to 6 months and sometimes up to a year. Your surgeon’s protocol comes first, and timings vary with what was done and with each surgeon.
The question that matters most is what else was done during the operation. If the surgeon also repaired the rotator cuff or the labrum (the rim of cartilage around the socket), your recovery follows that repair instead, with a longer sling time and a slower plan. Check your operation note, or ask your surgeon which procedures you had.
Key takeaways
- Decompression alone: sling for comfort, usually a few days to 2 weeks, with early movement encouraged.
- Full recovery: typically 3 to 6 months, sometimes up to 12 months.
- Added procedures: a rotator cuff or labral repair at the same time means a slower, protected plan.
- Night pain: common for the first few weeks and often the last symptom to settle.
- Protocol: your surgeon’s protocol comes first; timings vary with what was done and with each surgeon.
Where are you right now?
- First 2 weeks: wound care, sleep and early movement. Start with days 1 to 3 and the night pain answer.
- Weeks 2 to 6: the sling is usually off and movement is building. See weeks 2 to 6 and the stiffness answer.
- 6 to 12 weeks: strengthening and longer days at work. See weeks 6 to 12 and “If it isn’t going to plan”.
- 3 months on: heavier work, overhead tasks and sport. See months 3 to 6 and the “When can I…” table.
What decompression involves
Subacromial decompression is keyhole surgery on the space above the rotator cuff, under the bony tip of the shoulder blade (the acromion). The surgeon usually removes the inflamed bursa, a fluid-filled cushion in that space, and may shave the underside of the acromion. Common add-ons include trimming the end of the collarbone (distal clavicle excision), releasing or reattaching the biceps tendon, or a rotator cuff or labral repair.
Week by week, then month by month
These timings are for decompression without a repair.
- Days 1 to 3: The arm may be numb from a nerve block for the first day. Pain often peaks as the block wears off. A sling is for comfort. Elbow, wrist and hand movement starts straight away, and many people begin gentle pendulum swings.
- Weeks 1 to 2: Wounds are checked and stitches are usually removed around 10 to 14 days. Assisted movement, using your other hand or a table to help, often starts. Most people stop using the sling during this time.
- Weeks 2 to 6: Active movement through a comfortable range builds. Reaching to shoulder height gets easier. Light use for eating, dressing and typing is usually fine. Aching after a busy day is common.
- Weeks 6 to 12: Strengthening with light resistance starts, focused on the rotator cuff and the muscles around the shoulder blade. Overhead reaching improves. Night pain usually eases during this period.
- Months 3 to 6: Strength and endurance build. Most people return to heavier work and many sports here, one step at a time.
- Months 6 to 12: Some people still notice aching after heavy or overhead work. Gains continue more slowly.
Is this normal?
- Night pain: Yes. Lying flat often feels worse for the first few weeks. Sleeping propped up with a pillow under the forearm usually helps.
- Swelling: Fluid used during keyhole surgery can make the shoulder look puffy for the first few days, and bruising can spread down the arm. It usually settles within 1 to 2 weeks.
- Stiffness: Some is expected. It should ease week by week as you move. Stiffness that is getting worse after week 4 is worth raising with your physical therapist (PT).
- Clicking: Painless clicking is common as movement returns and usually fades.
- Numbness near the scars: Small patches of numb skin around the small cuts are common and usually shrink over months.
- Low mood: Broken sleep wears people down. If feeling flat lasts more than a couple of weeks, tell your doctor.
If it isn’t going to plan
It is week 8. Putting on a jacket still makes you wince, and reaching to the top shelf brings back the pain you had before surgery. The thought in your head is: “The operation was supposed to take care of this.”
The belief that often fails here is that surgery alone settles the shoulder. Decompression changes the space above the tendon. The rotator cuff and the muscles around the shoulder blade still need weeks of graded strengthening to tolerate overhead work again. Too little load, too much too soon or a long gap in exercises can all slow things down.
Pain rising after week 6, stiffness that keeps worsening, or weakness that is not improving are reasons to get assessed. Possible causes include post-surgery stiffness, an irritated tendon or pain coming from the neck. Questions to ask your PT or surgeon:
- Is my range where you would expect at this stage?
- Could this be stiffness, the tendon or my neck?
- Do I need a scan or a change in my exercise plan?
- What should I be able to do 4 weeks from now?
When can I…
| Activity | Typical range |
|---|---|
| Shower | Usually after 2 to 5 days with a waterproof dressing; no soaking until the wounds have healed |
| Sleep in bed | Propped up for 1 to 4 weeks is common; lying on the operated side often takes 6 to 12 weeks |
| Drive | Often 2 to 6 weeks, once the sling is off and you can control the wheel safely |
| Desk work | Often 1 to 3 weeks, with breaks |
| Lift | Light items at waist height from about 2 to 4 weeks; heavier lifting often from 8 to 12 weeks |
| Reach overhead | Light reaching often from 4 to 8 weeks; repeated or loaded overhead work often from 3 months |
| Manual work or sport | Often 3 to 6 months, depending on the job or sport |
Your surgeon’s protocol comes first. Timings vary with what was done and with each surgeon, and a repair at the same operation means longer.
What was done inside the shoulder decides your timeline more than the name of the operation.
Call your local emergency number or go to the emergency department if
- Sudden breathlessness or chest pain: especially with a racing heart.
- A cold, pale or blue hand: on the operated side.
See a doctor today if
- Wound redness or discharge: spreading redness, warmth, pus or a bad smell from any of the small cuts.
- Fever: 100.4°F (38°C) or higher, or shaking chills.
- Calf swelling or pain: in one leg.
- Numbness or weakness spreading: in the arm or hand once the nerve block has worn off.
- Uncontrolled pain: pain your prescribed medicines are not controlling.
Get it checked soon if
- Pain rising after week 6: instead of easing.
- Stiffness getting worse after week 4: despite doing your exercises.
- New weakness lifting the arm: especially after a fall or a sudden jolt.
More on this area: surgery recovery guides.
Recovery after decompression depends less on the operation and more on the months of strengthening that follow.
Written by Louise Yow, Neck & Shoulder Physio.